'It's becoming the centre of everything': a qualitative study using Patient Journey Mapping to examine the impact of social factors on healthcare interactions and disease outcomes for people living with rheumatoid arthritis.
5 affiliations
- 1Rheumatology Unit, The Queen Elizabeth Hospital, Woodville, SA, Australia.
- 2School of Medicine, College of Health, Adelaide University.
- 3School of Nursing and Midwifery, College of Health, Adelaide University.
- 4Rheumatology Unit, Royal Adelaide Hospital.
- 5School of Medicine, College of Health, Adelaide University, Adelaide, SA, Australia.
Abstract
Objectives
Disadvantageous socioeconomic status (SES) is associated with poorer disease outcomes for people living with rheumatoid arthritis (RA). We aimed to determine how people living with both RA and socioeconomic disadvantage navigate the healthcare system. In particular, we aimed to determine how their SES influences their interactions with the healthcare system and how it modifies the care they receive, influencing health outcomes.Methods
This was a qualitative study utilizing patient journey mapping techniques. In-depth, semi-structured interviews were conducted by two interviewers. Interview transcripts were coded, and reflexive thematic analysis (TA) was undertaken through sequential rounds of theme generation until thematic consensus was achieved. Themes were synthesized and interpreted using the cumulative complexity (CC) model and candidacy framework (CF).Results
Following purposeful sampling, 42 individuals met inclusion criteria, and interviews were ultimately arranged with eight individuals [50% female, median age 58.5 (IQR 56-66.5)]. Interviews lasted mean 88.5 min (SD 13.6). Most participants were unemployed and receiving social benefits. Six key themes were identified: the challenges of acknowledging and attributing symptoms, building health literacy, maintaining effective relationships with healthcare staff, managing treatment challenges, living with trauma and adapting to chronic illness.Conclusion
Individuals with low SES have unique experiences of RA care, influencing all aspects of their RA health journey. Using the CC and CF, the themes identified in this study highlight actionable strategies to improve care pathways to better support individuals living with greater cumulative complexity and disadvantage.
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BibTeX
@article{russell2026becoming,
title = {{'It's becoming the centre of everything': a qualitative study using Patient Journey Mapping to examine the impact of social factors on healthcare interactions and disease outcomes for people living with rheumatoid arthritis.}},
author = {Oscar Russell and Angela Brown and Carlee Ruediger and Rachel J Black and Catherine L Hill and Elizabeth Hoon},
journal = {Rheumatology advances in practice},
year = {2026},
month = oct,
doi = {10.1093/rap/rkag121},
url = {https://europepmc.org/article/MED/42927399},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - 'It's becoming the centre of everything': a qualitative study using Patient Journey Mapping to examine the impact of social factors on healthcare interactions and disease outcomes for people living with rheumatoid arthritis.
AU - Oscar Russell
AU - Angela Brown
AU - Carlee Ruediger
AU - Rachel J Black
AU - Catherine L Hill
AU - Elizabeth Hoon
PY - 2026
DA - 2026/10/10
JO - Rheumatology advances in practice
DO - 10.1093/rap/rkag121
UR - https://europepmc.org/article/MED/42927399
AB - Objectives Disadvantageous socioeconomic status (SES) is associated with poorer disease outcomes for people living with rheumatoid arthritis (RA). We aimed to determine how people living with both RA and socioeconomic disadvantage navigate the healthcare system. In particular, we aimed to determine how their SES influences their interactions with the healthcare system and how it modifies the care they receive, influencing health outcomes.Methods This was a qualitative study utilizing patient journey mapping techniques. In-depth, semi-structured interviews were conducted by two interviewers. Interview transcripts were coded, and reflexive thematic analysis (TA) was undertaken through sequential rounds of theme generation until thematic consensus was achieved. Themes were synthesized and interpreted using the cumulative complexity (CC) model and candidacy framework (CF).Results Following purposeful sampling, 42 individuals met inclusion criteria, and interviews were ultimately arranged with eight individuals [50% female, median age 58.5 (IQR 56-66.5)]. Interviews lasted mean 88.5 min (SD 13.6). Most participants were unemployed and receiving social benefits. Six key themes were identified: the challenges of acknowledging and attributing symptoms, building health literacy, maintaining effective relationships with healthcare staff, managing treatment challenges, living with trauma and adapting to chronic illness.Conclusion Individuals with low SES have unique experiences of RA care, influencing all aspects of their RA health journey. Using the CC and CF, the themes identified in this study highlight actionable strategies to improve care pathways to better support individuals living with greater cumulative complexity and disadvantage.
SN - 2514-1775
ER -