Stigma, Lost Autonomy, Reclaimed Identity, and Uncertainty Around Safe Movement: A Qualitative Interview Study of Physical Activity in Gout

Abstract

To explore patients' experiences and perceptions of physical activity in the context of gout and gout flares. Interpretive description informed the design of this qualitative study. Individual interviews were conducted with 25 people with gout. An interview guide was used to lead discussions, focusing on participants' experiences of gout flares, physical activity engagement, and the perceived impact of flares on activity levels. Key questions were designed to capture culturally specific understandings and experiences related to gout and physical activity. Interviews were audio-recorded and transcribed verbatim. Data were analysed using reflexive thematic analysis. Four themes were generated from the data: (1) The experience of physical activity is shaped by societal misconceptions about gout; (2) A loss of physicality comes with a loss of autonomy; (3) Reclaiming body and identity through physical activity; and (4) Living with uncertainty: wanting to be active but not knowing how. Gout flares disrupted mobility, independence, work, family roles, and identity. Participants described stigma, fear of judgement, activity modification, pacing and uncertainty about whether exercise could trigger flares or damage joints, particularly in the absence of gout-specific advice. This study offers new insights into how societal misconceptions about gout influence the patient experience of physical activity, including loss of autonomy, identity reconstruction through movement, and uncertainty around safe exercise. These findings may inform future intervention development, and patient-centred physical activity guidance that supports people with gout to move safely, confidently, and meaningfully.