Challenges nurses face in providing care to older patients with rheumatoid arthritis: A qualitative study

Objectives This study aims to identify challenges nurses face in providing care to older patients with rheumatoid arthritis (RA) in Japan. Methods Nurses certified by the Japan Rheumatism Foundation were requested via mail to describe challenges in providing care to older RA patients. Qualitative content analysis was used. Results One hundred and eighty-two issues were identified from 152 responses. Twenty categories were grouped into seven components, five of which focused on patients: (1) lack of patient understanding, (2) lack of understanding and support from surrounding people, (3) numerous comorbidities and complications, (4) challenges related to physical strength, and (5) financial issues. Two focused on nurses: (6) lack of knowledge of nurses and (7) inadequate systems and environment in the workplace. Various difficulties, such as polypharmacy due to multimorbidity, lifestyle issues due to aged couples or those living alone, and inadequate decision-making and informed consent due to cognitive decline, were also identified. Conclusions Nurses experienced numerous medical and nonmedical difficulties in providing care to older RA patients. Assessing patients' comprehension and self-management and grasping their situations at home are necessary. Along with the improvement of nurses' knowledge and skills, support from their workplace and multidisciplinary team care, including families, are crucial.