Experiences With Complementary and Integrative Health Among People With Rheumatoid Arthritis and Systemic Lupus Erythematosus: A Qualitative Study
Bibliographic record
Abstract
OBJECTIVE: Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are chronic immune-mediated inflammatory diseases often complicated by persistent pain and fatigue, despite cutting-edge pharmacological treatments. Lifestyle medicine (LM) and complementary and integrative health (CIH) offer adjuvant therapies with the potential to alleviate these symptoms, but little is known about patients' experiences with these modalities. METHODS: This qualitative study explored the use of LM and CIH among English- and Spanish-speaking patients with RA and SLE. We conducted 5 focus groups using an original semistructured interview guide to examine participants' experiences with, and barriers to using, LM and CIH. Group discussions were recorded, transcribed verbatim, translated, and analyzed in a multistep iterative process to identify frequencies and thematic trends. RESULTS: Thirty-nine participants with RA or SLE discussed using LM and CIH modalities to manage their disease in 130 mentions. Diet was the most frequently discussed LM modality, with participants noting specific foods that exacerbated or alleviated symptoms. Traditional Chinese medicine and natural products were the most-discussed CIH approaches, and participants expressed a strong interest in exploring additional CIH modalities to mitigate symptoms. The primary barriers to using LM and CIH were uncertainty regarding safe and effective practices and high out-of-pocket expenses. CONCLUSION: Patients with RA and SLE are highly interested in using LM and CIH to manage their conditions, but many are unsure which adjunctive treatment approaches are safe and effective. More research on LM and CIH modalities is needed to facilitate clear, evidence-based answers to these common patient questions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.008 | 0.007 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".