Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives

Abstract Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease primarily affecting the sacroiliac joints and spine, leading to chronic pain, fatigue, and reduced mobility. The diagnostic delay for axSpA is often long, causing significant physical, psychological, and social burdens for...

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Main Authors: Susann May, Greta Nordmann, Franziska Gabb, Katharina Boy, Magali Wagner, Niklas Ohm, Hanna Labinsky, Johannes Knitza, Sebastian Kuhn, Martin Heinze, Martin Welcker, Felix Muehlensiepen
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Rheumatology
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Online Access:https://doi.org/10.1186/s41927-025-00465-3
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author Susann May
Greta Nordmann
Franziska Gabb
Katharina Boy
Magali Wagner
Niklas Ohm
Hanna Labinsky
Johannes Knitza
Sebastian Kuhn
Martin Heinze
Martin Welcker
Felix Muehlensiepen
author_facet Susann May
Greta Nordmann
Franziska Gabb
Katharina Boy
Magali Wagner
Niklas Ohm
Hanna Labinsky
Johannes Knitza
Sebastian Kuhn
Martin Heinze
Martin Welcker
Felix Muehlensiepen
author_sort Susann May
collection DOAJ
description Abstract Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease primarily affecting the sacroiliac joints and spine, leading to chronic pain, fatigue, and reduced mobility. The diagnostic delay for axSpA is often long, causing significant physical, psychological, and social burdens for patients and their relatives. This study aims to explore the patient journey of individuals with axSpA and their relatives within the German healthcare system, identifying key challenges and unmet needs from symptom onset to diagnosis and treatment. A qualitative approach was employed, involving structured interviews with axSpA patients and their relatives. Participants were selected through purposive sampling to ensure diverse representation. Data collection involved individual telephone interviews, which were transcribed and analyzed using Kuckartz’s structured qualitative content analysis framework. The patient journey was characterized by four distinct phases: Time before diagnosis, Diagnosis, After the diagnosis, and Current treatment. Participants reported significant psychological and emotional burdens, with many experiences attributed to chance encounters with knowledgeable healthcare professionals. Key issues included a lack of awareness among healthcare professionals, diagnostic delays, and inadequate psychological support. The perspectives of patients and their relatives highlighted the significant psychological burden they both experience throughout the journey. This underscores the need for services that cater not only to patients but also to their relatives. The study highlights critical gaps in the current healthcare system regarding the diagnosis and care of axSpA patients. To improve care, systematic efforts are needed to enhance awareness, reduce diagnostic delays, integrate psychological support, and provide comprehensive information throughout the patient journey for both, patients and relatives. Effective care should not rely on chance; systematic improvements are necessary to ensure consistent, high-quality care.
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spelling doaj-art-89697c9b8d8e444fb743e5e28cebfb8e2025-08-20T02:13:03ZengBMCBMC Rheumatology2520-10262025-02-019111110.1186/s41927-025-00465-3Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relativesSusann May0Greta Nordmann1Franziska Gabb2Katharina Boy3Magali Wagner4Niklas Ohm5Hanna Labinsky6Johannes Knitza7Sebastian Kuhn8Martin Heinze9Martin Welcker10Felix Muehlensiepen11Center for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolRheumatology/Clinical Immunology, Department of Internal Medicine II, University of WürzburgInstitute for Digital Health, University Hospital of Giessen and Marburg, Philipps-University MarburgInstitute for Digital Health, University Hospital of Giessen and Marburg, Philipps-University MarburgCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolMVZ for Rheumatology Dr. Martin Welcker GmbHCenter for Health Services Research, Faculty for Health Sciences, Brandenburg Medical SchoolAbstract Axial spondyloarthritis (axSpA) is an inflammatory rheumatic disease primarily affecting the sacroiliac joints and spine, leading to chronic pain, fatigue, and reduced mobility. The diagnostic delay for axSpA is often long, causing significant physical, psychological, and social burdens for patients and their relatives. This study aims to explore the patient journey of individuals with axSpA and their relatives within the German healthcare system, identifying key challenges and unmet needs from symptom onset to diagnosis and treatment. A qualitative approach was employed, involving structured interviews with axSpA patients and their relatives. Participants were selected through purposive sampling to ensure diverse representation. Data collection involved individual telephone interviews, which were transcribed and analyzed using Kuckartz’s structured qualitative content analysis framework. The patient journey was characterized by four distinct phases: Time before diagnosis, Diagnosis, After the diagnosis, and Current treatment. Participants reported significant psychological and emotional burdens, with many experiences attributed to chance encounters with knowledgeable healthcare professionals. Key issues included a lack of awareness among healthcare professionals, diagnostic delays, and inadequate psychological support. The perspectives of patients and their relatives highlighted the significant psychological burden they both experience throughout the journey. This underscores the need for services that cater not only to patients but also to their relatives. The study highlights critical gaps in the current healthcare system regarding the diagnosis and care of axSpA patients. To improve care, systematic efforts are needed to enhance awareness, reduce diagnostic delays, integrate psychological support, and provide comprehensive information throughout the patient journey for both, patients and relatives. Effective care should not rely on chance; systematic improvements are necessary to ensure consistent, high-quality care.https://doi.org/10.1186/s41927-025-00465-3RheumatologyAxial spondyloarthritisQualitative researchPatient journeyFamily care giver
spellingShingle Susann May
Greta Nordmann
Franziska Gabb
Katharina Boy
Magali Wagner
Niklas Ohm
Hanna Labinsky
Johannes Knitza
Sebastian Kuhn
Martin Heinze
Martin Welcker
Felix Muehlensiepen
Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
BMC Rheumatology
Rheumatology
Axial spondyloarthritis
Qualitative research
Patient journey
Family care giver
title Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
title_full Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
title_fullStr Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
title_full_unstemmed Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
title_short Between uncertainty and destiny: the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
title_sort between uncertainty and destiny the patient journey in axial spondyloarthritis care from the perspectives of patients and their relatives
topic Rheumatology
Axial spondyloarthritis
Qualitative research
Patient journey
Family care giver
url https://doi.org/10.1186/s41927-025-00465-3
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