Coping Strategies, Psychological Impact, and Support Preferences of Black Men with Rheumatic Diseases

Gender plays an important role in how men and women learn to cope, adapt and self-manage the physical and psychosocial consequences and lifestyle changes associated with living with a long-term health condition. In Rheumatoid Arthritis, men have been shown to place more importance on maintaining activities such as paid work and contact sports to balance the loss of masculinity that RA brings. Social support is key to self-management and coping, but many men have poorer social capital than women. Further, men are more likely than women to have difficulty in expressing emotional distress and exhibit behaviour which hinders offers of support (e.g. increased reliance on alcohol).10 Healthcare support services that are tailored to reflect men's gender-specific needs have been recommended as a result.

Early evidence suggests Rheumatic Diseases (RDs) impact men in specific ways with respect to their feeling(s) of masculinity. Research has shown that culture and ethnicity interplays with masculinity in important ways in other conditions, but little is known about the experience of RDs among black and minority ethnic (BME) men. Research indicates that RDs are underreported in BME with specific RDs such as systemic lupus and systemic sclerosis reportedly occurring more frequently in patients of African descent. This studentship aims to explore experiences of men from diverse black ethnic backgrounds (African/Caribbean/American) and begin to understand their coping strategies for RDs management relating to their masculinity in the context of their culture, ethnicity, age and social economic status.

This will be explored through:
1. Case studies with 5-6 black men to understand the impact on their lives and create vignettes to inform the subsequent focus group discussions
2. Focus groups: Approx 6 with 4-6 participants per group to further understand the experiences of black men with rheumatic diseases
3. Q-methodology study: with 35-40 participants to identify groups of black men with RDs who share similar experiences, coping strategies and support preferences
4. A Delphi study to find consensus on the experiences, coping strategies and support preferences of black men with RDs
5. To methodologically compare Q-methodology and Delphi as consensus techniques

These findings will provide novel understanding of the experiences, coping styles, and support needs of black men with RDs. Findings will be presented to groups of clinicians, thus providing a greater understanding of the needs of black men and having the potential to improve interactions with black men in rheumatology clinics. Short term, this studentship has the potential to improve delivery of care for black men with RDs. Long-term, these findings will inform the design of an appropriate self-management intervention for this group. This studentship will also make a direct comparison between two consensus techniques informing future research practice.