'It's just a great muddle when it comes to food': a qualitative exploration of patient decision-making around diet and gout.

Objective: Our aim was to understand whether, why and how patients choose to modify their diets after developing gout.

Methods: We conducted an inductive thematic secondary analysis of qualitative data from 43 interviews and four focus groups with UK participants with gout ( = 61).

Results: Participants commonly initiated dietary changes as part of a self-management strategy for gout.

Interpreting intracorporeal landscapes: how patients visualize pathophysiology and utilize medical images in their understanding of chronic musculoskeletal illness.

Medical science and other sources, such as the media, increasingly inform the general public's understanding of disease. There is often discordance between this understanding and the diagnostic interpretations of health care practitioners (HCPs). In this paper - based on a supra-analysis of qualitative interview data from two studies of joint pain, including osteoarthritis - we investigate how people imagine and make sense of the pathophysiology of their illness, and how these understandings may affect self-management behavior.

Challenges of diagnosis and management of giant cell arteritis in general practice: a multimethods study.

Background: In the UK, general practitioners (GPs) are usually the first medical contact for patients with suspected giant cell arteritis (GCA). While rare, it is critical not to miss, as delayed treatment can lead to significant complications including permanent visual loss. To date, little is known about the approach and challenges to diagnosis and management of GCA by GPs.

What is the impact of giant cell arteritis on patients' lives? A UK qualitative study.

Objectives: Clinical management of giant cell arteritis (GCA) involves balancing the risks and burdens arising from the disease with those arising from treatment, but there is little research on the nature of those burdens. We aimed to explore the impact of giant cell arteritis (GCA) and its treatment on patients' lives.

Methods: UK patients with GCA participated in semi-structured telephone interviews.

Where does good quality qualitative health care research get published?

This short report aims to give some insight into current publication patterns for high-quality qualitative health research, using the Research Excellence Framework (REF) 2014 database. We explored patterns of publication by range and type of journal, by date and by methodological focus. We also looked at variations between the publications submitted to different Units of Assessment, focussing particularly on the one most closely aligned with our own research area of primary care.

A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout.

Background: Although international guidelines encourage urate lowering therapy (ULT) for people who have more than two attacks of gout, only 30 % of patients are prescribed it and only 40 % of those adhere to the treatment. The aim was to explore reasons for this through an exploration of patient experience and understanding of ULT treatment for gout.

Methods: A qualitative study was conducted throughout the United Kingdom.

"Why me? I don't fit the mould … I am a freak of nature": a qualitative study of women's experience of gout.

Background: Gout is more common in men, and is often perceived by both patients and health practitioners to be a disorder of men, but its prevalence in women is increasing. Little is known about women's experience of gout and the impact it has on their lives. It is important for practitioners to be aware of these areas, given the increasing numbers of women with gout they are likely to see in the future.

Mapping patients' experiences from initial symptoms to gout diagnosis: a qualitative exploration.

Objective: To explore patients' experiences from initial symptoms to receiving a diagnosis of gout.

Design: Data from in-depth semistructured interviews were used to construct themes to describe key features of patients' experiences of gout diagnosis.

Participants And Setting: A maximum variation sample of 43 UK patients with gout (29 men; 14 women; age range 32-87 years) were recruited from general practices, rheumatology clinics, gout support groups and through online advertising.

'Keeping going': chronic joint pain in older people who describe their health as good.

It is common for people with chronic conditions to report their health as good, although models of healthy ageing do not account for this. The concept of successful ageing focuses on overcoming problems, in contrast to the concept of resilience, which can acknowledge vulnerability. Osteoarthritis (OA) is the main cause of joint pain in older people, but research in this area has tended to focus on OA as an illness.

Extending the authority for sickness certification beyond the medical profession: the importance of 'boundary work'.

Background: The study aimed to explore the views of general practitioners (GPs), nurses and physiotherapists towards extending the role of sickness certification beyond the medical profession in primary care.

Methods: Fifteen GPs, seven nurses and six physiotherapists were selected to achieve varied respondent characteristics including sex, geographical location, service duration and post-graduate specialist training. Constant-comparative qualitative analysis of data from 28 semi-structured telephone interviews was undertaken.

Older People's Perceptions of Remaining Physically Active and Living With Chronic Pain.

Active aging, using the conventional sense of activity, might be difficult to achieve for people with chronic musculoskeletal pain (CMP). Given that a large number of older people will develop CMP, it is important to consider a broader conceptualization of activity and how this might fit into discourses of aging. We report findings from a study of the experiences of chronic pain in the daily life of 60 older people.

Behaviour change and social blinkers? The role of sociology in trials of self-management behaviour in chronic conditions.

Individual-focused self-management interventions are one response to both an ageing society and the purported increase in chronic conditions. They tend to draw on psychological theories in self-management interventions, but over-reliance on these theories can reinforce a narrow focus on specified attitudinal and behavioural processes, omitting aspects of living with a chronic condition. While advances have been made in health behaviour change theory and practice, scant attention has been paid to the social, with the question of social context remaining under-theorised and under-explored empirically.

Ethical issues in the reuse of qualitative data: perspectives from literature, practice, and participants.

In this article, we explore ethical issues in qualitative secondary analysis through a comparison of the literature with practitioner and participant perspectives. To achieve this, we integrated critical narrative review findings with data from two discussion groups: qualitative researchers and research users/consumers. In the literature, we found that theoretical debate ran parallel to practical action rather than being integrated with it.

Exploring the relationship between multi-morbidity, resilience and social connectedness across the lifecourse.

Multi-morbidity is receiving considerable attention in public policy, health and social care. From the perspective of the individual, multi-morbidity is a more complex experience than solely having a clinical diagnosis. In this article, we will argue that understanding multi-morbidity can be facilitated by considering the relationship between adversity (in this case multi-morbidity), resilience and social connectedness within a life course framework.

Perceptions of joint pain and feeling well in older people who reported being healthy: a qualitative study.

Background: Older people often view osteoarthritis as a part of normal ageing and see themselves as healthy despite painful joints. Professionals have mixed views about this. One concern is that seeing osteoarthritis as a result of 'wear and tear' leads to restricting exercise in order to avoid further wear.

A woman living with osteoarthritis: A case report.

Osteoarthritis is a common condition that is typically associated with older adults. Other causes of osteoarthritis, such as those cases resulting from childhood Perthes disease, can affect younger people and frequently have a major impact on the lives of those affected. This case report describes the experiences of one patient with osteoarthritis, using examples of her poetry to illustrate her social, psychological and emotional transformation.

Experiencing and controlling time in everyday life with chronic widespread pain: a qualitative study.

Background: Chronic widespread pain (CWP) affects 10% of adults and often causes significant disability in everyday life. Research on time in chronic conditions has focused on biographical disruption and perceptions of past and future. However, more mundane aspects of time are also disrupted in a condition such as CWP, which is uncertain on a minute-to-minute, day-to-day basis, as well as in the longer term.

Experiencing chronic widespread pain in a family context: giving and receiving practical and emotional support.

The impact of pain and chronic illness on the family has been documented, but there is little information about living with chronic widespread pain in the context of the family. This article uses data from a qualitative study of the experience of living with chronic widespread pain to examine the experience and meaning of support for people with this condition in the context of their families. It focuses on the varying, dynamic and reciprocal nature of practical and emotional support in the family.

Remaking the future: contemplating a life with chronic widespread pain.

Objectives: This paper reports findings from a larger study that aimed to explore how people with chronic widespread pain experience, understand and make meaning of their 'condition', and attempt to influence or exert control over their pain. This included an exploration of sufferers' understanding of the past and future as well as of their present situation.

Methods: A combination of data generation methods was used, including lifegrid interviews, diaries and diary interviews, with eight people with chronic widespread pain.

Is chronic widespread pain biographically disruptive?

This article draws on findings from a study of eight people (aged 40-60) with chronic widespread pain and their families, living in the West Midlands area of the UK. Data were generated through a series of in-depth interviews, based on a lifegrid and on participants' diaries. We explore the experience of chronic widespread pain in the context of sufferers' biographies, examining how people attempt to account for and give meaning to their pain onset and development and how they remake identity following disruption to their lives.

Establishing the (extra)ordinary in chronic widespread pain.

Sufferers of chronic illness face delegitimation of their condition and threats to their identities. One way of establishing the legitimacy of their position is for sufferers of chronic illness to emphasize the 'ordinary' in their accounts. Sufferers of conditions which are chronic, invisible and contested, such as chronic widespread pain, have the same, and possibly greater, need to legitimize their condition and refute allegations of 'malingering' or psychological instability.

GPs' perceptions of the role of DEXA scanning: an exploratory study.

Background: Current recommendation are that women with clinical indicators of low bone mineral density should be offered a DEXA (dual energy X-ray absorptiometer) scan to help assess the need for treatment, but little is known about GPs' attitudes towards DEXA scans.

Objective: Our aim was to explore GPs' beliefs about diagnosis and management of osteoporosis, including the role that DEXA scanning can play.

Methods: Semi-structured interviews with five GPs in the North Staffordshire area were used to explore how GPs make decisions about diagnosis and treatment of osteoporosis, including the use of scans and the application of potential clinical risk factors to decisions about screening and treatment.

Osteoporosis: what are the implications of DEXA scanning 'high risk' women in primary care?

Background: Current recommended practice for the use of dual X-ray absorptiometry (DEXA) scans in screening for osteoporosis is to concentrate on women at 'high risk'.

Objective: We have applied such a screening strategy, in a general practice setting, to estimate the number of women requiring scans.

Methods: A two-phase survey was carried out: (i).

"I'd rather go and know": women's understanding and experience of DEXA scanning for osteoporosis.

Objective: To explore women's knowledge and understanding of osteoporosis and of dual energy x-ray absorptiometer (DEXA) scans; the factors influencing their decision to have a scan and their experience of undergoing a DEXA scan.

Design: In-depth interviews (using a topic guide) were carried out with 12 women [before a DEXA scan and after they had discussed the results with their general practitioner (GP)] and with three women who chose not to have a scan.

Setting: Stoke-on-Trent, Staffordshire, UK.