• Caroline A Flurey, Sarah Hewlett, Karen Rodham, Alan White, Robert Noddings, and John R Kirwan.
• Universtiy of the West of England, Bristol, UK.
• BMJ Open. 2016 Oct 3; 6 (10): e012051.

ObjectiveTo identify typologies of experiences and coping strategies of men with rheumatoid arthritis (RA).DesignQ-methodology (a qualitative and quantitative approach to grouping people according to their subjective opinion). Men with RA sorted 64 statements relating to their experience of living with RA according to level of agreement across a normal distribution grid. Data were examined using Q-factor analysis.SettingRheumatology outpatient departments in the UK.Participants30 of 65 invited men with RA participated in this study (46%).ResultsAll participants ranked highly the need to be well informed about their medication and the importance of keeping a positive attitude. 2 factors describing the experiences and coping strategies of male patients living with RA were identified: factor A: 'acknowledge, accept and adapt' (n=14) take a proactive approach to managing the impact of RA and find different ways of doing things; while factor B: 'trying to match up to a macho ideal' (n=8) are determined to continue with their pre-RA lives, and therefore push themselves to carry on even if this causes them pain. They are frustrated and angry due to the impact of RA but they internalise this rather than directing it at others.ConclusionsWhile some men adapt to their RA by renegotiating their masculine identity, others struggle to relinquish their traditional masculine roles. Further research is needed to identify whether the finding that there are 2 distinct groups of men with RA can be generalised, and if so whether the differences can be explained by clinical, social or psychological factors, which may inform different therapeutic approaches.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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