Abstract
Previous work highlighted a national deficit in pediatric rheumatologists and allied health professionals with a geographic maldistribution in Canada. The aim of this current study was to further evaluate the clinical care structures and processes in place within Canadian pediatric rheumatology centres that promote or impede care delivery, from the perspective of pediatric rheumatology health care providers. Data were collected through semi-structured interviews with pediatric rheumatologists and Advanced Clinician Practitioners in Arthritis Care (ACPACs) across Canada. Analysis was performed by two investigators following the four stages of qualitative content analysis: decontextualisation, recontextualisation, categorisation, and compilation. Data were analyzed through latent analysis due to the informal nature of interviews, and themes were identified iteratively. Twelve individuals (9 pediatric rheumatologists, 3 allied health professionals) agreed to participate in the study. Interviewees practiced across Canada with a range of career experience. The following themes emerged: 1) Geographic barriers negatively affect access to care, 2) ACPAC practitioners and community pediatric rheumatologists improve access to care, and 3) There is inconsistent access to physiotherapists, social workers, and occupational therapists who are knowledgeable about pediatric rheumatology care and disease. Although there was variation in pediatric rheumatology practice across Canada, there were common themes of supports and barriers to clinical care. The description of these themes can help guide pediatric rheumatology practice by highlighting thriving practice patterns and concomitantly emphasize the deficits in resources and functioning that can advise future advocacy work.
Published Version
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