Care-seeking pathways, care challenges, and coping experiences of rural women living with rheumatoid arthritis in Odisha, India
Authors
Sanghamitra Pati
Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
Krushna Sahoo
Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
Mousumi Samal
Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
Sunita Jena
Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
Pranab Mahapatra
Department of Psychiatry, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
Deepika Sutar
Indian Institute of Public Health, Bhubaneswar, Odisha, India
Bidyut Das
Clinical Immunology and Rheumatology, Department of Medicine, SCB Medical College and Hospital, Cuttack, Odisha, India.
Keywords:
Key words: care-seeking pathways, India, primary health care, rheumatoid arthritis
Abstract
Aim:
The aim of the study was to explore the care-seeking pathway of rural women living with rheumatoid arthritis (RA) and attending a tertiary health-care facility in Odisha, India.
RA is the third leading chronic health condition and causes severe pain and immense psychosocial stress. The prevalence of RA is three to four times higher in women than in men. Furthermore, in India, women delay care seeking due to the prevailing sociocultural norms. Women report more severe symptoms and greater disability; however, there is a lack of information on their care-seeking pathways.
Method:
We conducted 113 in-depth interviews among RA patients those who visited specialists at the outpatients’ Department of Rheumatology, SCB Medical College Hospital, a tertiary care hospital in Cuttack, Odisha, India. The grounded theory approaches were used for data analysis.
Findings:
The key findings included physical pain and psychosocial stress in relation to RA, cultural issues in relation to RA, mapping of the health-care providers for RA, the first point of cares and changes in care-seeking pathways, the perceived challenge for seeking health-care, and coping strategies of patients and social supports. This study explored that the RA patients seek care from multiple providers – untrained, trained and specialist without any gatekeeping. However, the primary health centers were the first point of care for maximum patients due to accessibility and affordability. Furthermore, follow-up care is significant to prevent complication among RA patients; the primary health centers are the gateway for keeping RA patients. Hence, the availability of RA trained providers at primary health center including interprofessional care, such as physiotherapy providers, and proper referral system is essential to convalesce care-seeking pathways.
Key words: care-seeking pathways, India, primary health care, rheumatoid arthritis
Click on "Archives" to access the full archive of scientific preprints. You may use the categories and the search functionality to find select preprints you're interested in.
