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'If I didn't have RA I wouldn't give them house room': the relationship between RA, footwear and clothing choices.

OBJECTIVES
The aim of this study was to develop a greater understanding of the impact of RA on women's self-image and self-presentation via an exploration of their clothing choices.


METHODS
Located within a qualitative symbolic interactionist approach, 15 women with RA (age range 38-74 years, disease duration 1-47 years) each participated in two interviews. The first explored the impact of RA on their feelings about their bodies and their appearance; the second explored the factors that informed their clothing choices and the way they presented themselves. All interviews were digitally recorded and transcribed verbatim, digital photographs of the women's clothes and shoes were taken. Data were analysed jointly by both authors using thematic network analysis.


RESULTS
Shoes were identified as greatly influencing the women's clothing choices and how they presented themselves. Three themes were identified that explored the structural and symptomatic impact of RA on the women's feet, the strategies they had developed to resolve their footwear needs outside of prescription footwear and the significant impact that footwear had on their clothing choices and self-presentation. Insights from these data highlight the polarity that exists between the clinical, functional attitudes towards shoes and their social status.


CONCLUSION
While aesthetic issues challenge the acceptability of prescription footwear, problems also exist with the functionality and comfort of footwear available on high streets. A more collaborative approach to the design of footwear is required for both prescription and mainstream footwear to meet the needs of women with RA.