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Beliefs and understandings table.pdf
Individual and community beliefs about gout present a significant barrier to successful long-term treatment of gout. It can be difficult for some whānau Māori and Pacific peoples with gout to decide to take long-term medicines, when concerns about harms of Western medicine in their whānau and families may not have been resolved in a satisfactory way.
Respectfully engaging with community groups and offering to raise awareness about the causes of gout and the treatment that is available can help to address community beliefs. Have members of your team who are highly regarded in your community, trained and available to do POC testing at these events, so people can find out what their uric acid levels are.
Where possible, invite a local rheumatologist or clinical nurse specialist (CNS) to attend the event with you to discuss other forms of arthritis as well.
Be prepared to undertake these activities on more than one occasion.
Some whānau Māori and Pacific peoples with gout might like to have someone set up regular get-togethers of those with gout to share experiences. Again, a member of your team might set up the first meeting and attend to do POC testing and arrange for any questions to be answered.
From the Whanganui GOUT STOP programme evaluation report: Specific to gout, the narrative and understanding around gout needs to change. When myths are busted for health care providers, patients, whānau and communities, there can be less stigma and more open communication. It can be easier to talk about, seek support, come to terms with a diagnosis and to involve whānau in care. This includes involving Māori communities, with whānau and kaumatua involved in this conversation.
| Widely held beliefs | Building a new understanding |
|---|---|
| Gout is not serious. | Gout is a serious condition if it’s not treated early with uric acid-lowering medicines such as allopurinol. Gout can lead to bone and joint damage as well as other health conditions such as type 2 diabetes, high blood pressure, high cholesterol, cardiovascular disease and kidney disease. |
Gout can also affect your job, and stop you doing all the things you want to do – with your family, your mates and in the community. | | Gout is not a long-term condition. | Gout is a long-term condition because you have high uric acid levels in your blood all the time. After each attack, more and more uric acid crystals form in your joints and damage the joint and bones.
You need to take uric acid-lowering medicines to stop your body producing so much uric acid. Over time, the crystals in your joints will dissolve and your joints and bones won’t be damaged. | | Gout is just painful acute attacks. | You’re right – gout is painful. You get gout attacks because you have high levels of uric acid in your body. You’ll keep on getting more painful gout attacks more often if you don’t take uric acid lowering medicines every day to bring your uric acid levels down. | | Gout is caused by eating too much meat or kaimoana/seafood or drinking too much beer or fizzy drinks. | You’re right – painful gout attacks often happen after you’ve eaten meat or seafood, or drunk beer or fizzy drinks. However, this is because your body already has high levels of uric acid as your kidneys hold onto uric acid.
If you take a daily medicine to bring your uric acid levels down, you’ll be able to eat small amounts of the food you love but have stopped eating because it has triggered your gout attacks. | | Gout can be managed by stopping eating and drinking foods that cause gout attacks. | For whānau Māori and Pacific peoples with gout, only 10% of the high levels of uric acid levels in your body are caused by food. 90% is caused by your genes, your kidneys and your weight. Almost everything we eat and drink causes our uric acid levels to go up. As you stop eating and drinking foods because they caused a gout attack, you’ll find that more and more foods cause your uric acid levels to go up and cause painful gout attacks. Because most whānau Māori and Pacific peoples have genes causing high uric acid levels in the body, you’ll need to take uric acid lowering medicine such as allopurinol every day to bring down your uric acid levels and stop painful gout attacks. | | Gout does not cause any long-term harm. | Each time you have a gout attack, sharp crystals form in your joints. Once the pain goes away, the crystals remain in your joints and damage your joints and bones. You’re often not aware of the crystals or the damage they are doing until it gets really bad. Each time you have a gout attack, more crystals form in your joint causing more damage to your joint and bones. | | Gout is not linked to other related health risks. | Gout is linked to other health conditions such as type 2 diabetes, high blood pressure, high cholesterol, cardiovascular disease and kidney disease. All these health conditions cause whānau Māori and Pacific peoples to die much earlier than other groups. | | Youth is a protective factor in gout. | Whānau Māori and Pacific peoples get more severe gout much earlier and more frequently than other groups. This means that young whānau Māori and Pacific peoples with gout need to start taking daily uric acid-lowering medicines such as allopurinol much earlier than other groups to stay healthy and prevent damage to joints and bones. | | Taking uric acid medicine every day means you are unhealthy. | Taking uric acid medicine every day is an important decision. Your decision means you’re taking care of your health, improving your quality of life and making sure you can work and do all the things you want to do – with your family, with your mates and in your community. |
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