FRI0728-HPR PERCEPTIONS OF PHYSICAL ACTIVITY IN INDIVIDUALS WITH RA – A QUALITATIVE THEMATIC SYNTHESIS
Authors: Nina Brodin, Emma Swärdh
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The effects of physical activity (PA) in rheumatoid arthritis (RA) are well documented and PA is besides pharmacological interventions considered a cornerstone in the treatment. Despite this, many individuals with RA does not reach recommended levels of PA. To highlight aspects involved in supporting a positive PA behavior it is important to understand the patients' perceptions of the phenomenon. Several qualitative studies have been conducted throughout the years, describing perceptions on physical activity in RA. <h3>Objectives</h3> The aim of this study is to review and synthesize the qualitative literature on physical activity in rheumatoid arthritis. <h3>Methods</h3> A purposive search in electronic databases (MEDLINE, CINAHL and Pedro) using combinations of terms such as "qualitative methods, qualitative study, interviews, physical activity, exercise and rheumatoid arthritis", from inception to July 2018 was carried out. Title/abstract and full- text screening were conducted independently by 2 researchers. Further, back-tracking of reference list of retrieved articles was made, and contacts were taken with known experts in the field. Studies were eligible if they qualitatively explored perceptions of different aspects of PA in individuals with RA. Eligible articles were appraised using the McMaster Critical review form. All relevant data were extracted from eligible articles and analyzed inductively using thematic analysis. <h3>Results</h3> 11 primary studies met the inclusion criteria. Studies were conducted in Denmark, Ireland, New Zealand, Sweden, United Kingdom and the United States of America. The sample includes 170 individuals with rheumatoid arthritis (129 women, 41 men, aged 21-83). Across the studies, preliminary themes were found: worries and fear (increasing symptoms, worsen the disease, safety), awareness of PA (knowledge, information, discussion), social support (competence, guidance, demands, joy), effects on health (retain independence, decrease symptoms, coping with the disease), body awareness (adaptation, pacing, listen to the body, self-efficacy) and determination (motivation, focus, goals, priorities, responsibility). A preliminary thematic map, interpreting the continuous interrelation between the themes and the disease itself was described. <h3>Conclusion</h3> It is important that the promotion of PA in individuals with RA is in line with individual challenges and resources, in order to enhance adoption and maintenance of PA behavior. In RA, the disease seems to pervade all aspects related to the individuals' perception of physical activity. Strategies to enhance this behavior should therefore include minimizing negative perceived consequences of physical activity by raising both cognitive and physical awareness. Another strategy could be focusing on finding proper social support either within health care or preferably outside of health care but with a sense of affinity. Finally, strengthening the individual's ability to use self-regulation strategies to overcome barriers should be emphasized. <h3>References</h3> [1] Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Medical Research Methodology. 2008;8:45. Doi: 10.1186/1471-2288-8-45 [2] Walsh D, Downe S. Meta-synthesis method for qualitative research: a literature review. Journal of Advanced Nursing. 2005;50(2):204-211. <h3>Disclosure of Interests</h3> None declared