The impact of the illness label ‘gout’ on illness and treatment perceptions in Māori (Indigenous New Zealanders)

• Main Authors: Nicola Dalbeth, Meihana Douglas, Kate MacKrill, Leanne Te Karu, Maria Kleinstäuber, Keith J. Petrie
• Format: Article
• Language: English
• Published: BMC 2020-04-01
• Series: BMC Rheumatology
• Subjects: Gout; Urate; Arthritis; Illness perceptions
• Online Access: http://link.springer.com/article/10.1186/s41927-020-00120-z

Abstract Background Despite contemporary advances in understanding pathogenesis and effective management of gout, beliefs about the disease continue to be focused on gout as a self-inflicted illness. The illness label itself may contribute to inaccurate perceptions of the disease and its management. In Aotearoa/New Zealand, Māori (Indigenous New Zealanders) have high prevalence of severe gout. The aim of this study was to examine the impact of the illness label ‘gout’ on perceptions of the disease and its management for Māori. Methods Māori supermarket shoppers (n = 172) in rural and urban locations were recruited into a study examining the perceptions about arthritis. Participants were randomised 1:1 to complete a questionnaire examining the perceptions of the same illness description labelled as either ‘gout’ or ‘urate crystal arthritis’. Differences between the two illness labels were tested using independent sample t-tests. Results ‘Gout’ was most likely to be viewed as caused by diet, whereas ‘urate crystal arthritis’ was most likely to be viewed as caused by aging. ‘Urate crystal arthritis’ was seen as having a wider range of factors responsible for the illness, including stress or worry, hereditary factors and chance. ‘Gout’ was less likely to be viewed as having a chronic timeline, and was perceived as being better understood. Dietary management strategies were seen as more helpful for management of the gout-labelled illness. Conclusions This study has demonstrated that for Māori, Indigenous New Zealanders who are disproportionately affected by gout, the illness label influences perceptions about gout and beliefs about management.