Aims This article details a qualitative study aiming to explore the impact of rheumatoid arthritis (RA) on participation in paid work during the first two years after diagnosis. Methods In-depth semi-structured interviews using the Model of Human Occupation Worker Role Interview were used to explore the impact of a diagnosis of RA on the participant's lived experience, the meaning of work from the participant's point of view, and whether there was any change in perception or attitude towards work and work ability since diagnosis. Qualitative methods were felt to be appropriate to capture the lived experience of participation and engagement in work. Interviews were conducted on entry to the study and were repeated at six-month follow-up. Transcripts from the interviews were subjected to interpretative phenomenological analysis. Findings Ten individuals with RA in paid employment participated in the study. The mean age was 38 years. The mean duration from diagnosis was 14.2 months. Participants identified work-specific changes and external lifestyle alterations made early in the disease trajectory to support maintenance of the worker role. The personal meaning of work and the importance of the worker role in shaping self-identity emerged as an important factor in determining work participation. Qualitative factors influenced the type and extent of changes made to work and determined the impact of RA on work. These findings suggest that from early in the disease course RA influences the individual's normal lifestyle and work participation. Conclusions Qualitative assessment of work participation demonstrated that paid work was affected in the early phase of RA. Work intervention needs to shift to encompass such factors which influence maintenance of the worker role.

A total of 73 responses were received from 25 nurses, 18 doctors and 30 physiotherapists, indicating a response rate of approximately 22%.

Background:The impact of inflammatory arthritis (IA) on occupational performance and on participation in meaningful life roles is recognised. However, limited research has explored how clinical services support broader life impact and participation restrictions associated with early disease as part of routine healthcare.This exploratory study was undertaken to describe how a novel multidisciplinaryled early arthritis service approach addresses client-identified participation restrictions in early IA.Methods: Qualitative Description (QD) approaches were used to explore perspectives of staff and clients of these multidisciplinary-led early arthritis services in Ireland. Data were gathered using focus groups with staff, and individual semistructured interviews with clients. Transcripts were analysed using thematic analysis.Results: Fifteen staff working in these services participated in the focus groups and 43 clients with IA participated in interviews (female n = 31); diagnosis duration ranged from 5 to 24 months. Participants described how the multidisciplinary-led service had a clear remit to address participation alongside traditional symptom management and provided automatic, immediate access to interventions focussed on identification and management of participation restrictions experienced in early disease. The service model utilised a delivery approach that allowed for ease of early access to a full multidisciplinary team and prolonged support. The most significant feature of the service approach was 'the centrality of the client' which influenced a person-centred approach to identification of needs and priorities for interventions. Conclusion:Findings indicate the role and value of this innovative multidisciplinary approach in addressing client-identified participation restrictions in routine clinical practice that is positively regarded by clients and staff.