Table 4.

Supporting statements for themes responding physical activity in rheumatoid arthritis.

Theme	Rheumatologists	Low active patients	Highly active patients
Communication	“We do these assessments for RA now, but how would we apply those to gear people to do the right types of activity and exercise?”	“She (rheumatologist) tells me to exercise.”	“If your rheumatologist tells you what will be good for you, you will listen to him. If he tells you how important exercise is, most of us will do it.”
	“I feel like I’m talking to them a lot but I’m not necessarily sure I am being effective.”		“Doctor’s could give you a prescription for exercise.”
Environment and access	“It’s (physical therapy) expensive and patients get really annoyed because they could spend an afternoon in therapy.”	“I would prefer to do swimming but there is nothing available I can afford.”	“Finding the right shoe is an issue when you have arthritis.”
	“I have a few patients who perceive going to the gym as the only way to get their exercise and gym memberships are expensive.”	“It’s difficult to be active when the weather is cold and snowy.”	“In the long run it (covering the cost of physical activity) might prove cost–effective to the insurance companies.”
Symptom management	“If you have a joint deformity or specific weak member that you want to build up, you do therapeutic exercises.”	“I just started an exercise program which I’ve never done before. What prompted me to do it was weight. “	“It just makes everything in your body work better.”
	“In an ideal world you’d want to spend equal time on that (exercise).”		“Exercise and medicine are a 1–2 punch.”
Social support	“... a peer supporter that can motivate you to exercise would be something to think about.”	“Doctors should organize support group because I found I learned a lot from other people.”	“You force yourself to just go out, you are with people. I am part of this world and I feel good about it.”
Mental health	“I don’t think they realize that it can really help them. It requires a mind shift on their part in some ways.”	“It’s (exercise) just best all around for mental health and you just feel more alive.”	“You feel so much better mentally.”
Breaking the cycle	“I don’t think the pain is going to get better w/out physical activity.”	“I’ve been in this pit that I’m trying to climb my way out of.”	“My philosophy has always been you can work through it.”
Personal routine	“I actually really focus on sedentary people. If it really looks like they haven’t been doing anything other than physical therapy and walking.”	“I know if I stop moving then I’m not going to be able to move.”	“I will get aggressively defensive of it (exercise) if somebody says, ‘Oh you know you don’t have to go to the gym today.’ Yeah, I do!”
	“I thinking a lot of them were motivated before they had their disease.”
Fear /staying in control	“Patients are more comfortable talking about pain than they are about dysfunction. I think in the back of their minds they’re worried about being crippled.”	“You have RA, the RA doesn’t have you.”	“Well you can control trying to be physically fit because, rationally, logically it will make you feel better.”
		“I never exercised in the past, I didn’t know what the right way to exercise was.”
Challenge/ intimidation	“Maybe that’s (personal exercise routine) why I have so much trouble relating to patients.”	“I stopped because. you just see people bent over like pretzels, I couldn’t do that. I felt so uncomfortable in a regular class.”	“I get really frustrated because when I’m walking on the treadmill and I see someone next to me running. It really bothered me.”

RA: Rheumatoid arthritis.