Understanding knee osteoarthritis from the patients’ perspective: a qualitative study

Abstract

BackgroundNo studies of Health Coach Interventions for knee OA sufferers that include patients’ perspectives have been published. The study assesses current clinical practice and primary care professionals’ advice from the patients’ perspective, in order to obtain a participative design for a complex intervention based on coaching psychology. Moreover, wants to analyse the experiences, perceptions, cognitive evaluation, values, emotions, beliefs and coping strategies of patients with knee osteoarthritis, and secondly the impact of these factors in the Self-management of this condition.MethodsIt is an interpretative qualitative study. The study included patients with diagnosis of knee osteoarthritis (OA) from 4 primary health care centres in Barcelona. A theoretical sampling based on a prior definition of participants’ characteristics was carried out. Ten semi-structured interviews with knee OA patients were carried out. A content thematic analysis was performed following a mixed-strategy text codification in Lazarus framework and in emerging codes from the data.ResultsThe results are structured in two blocks: Experiences and perceptions of informants and Experiences of knee osteoarthritis according to the Lazarus model. Regarding experiences and perceptions of informants: Some participants reported that the information was mostly provided by health professionals. Informants know which food they should eat to lose weight and the benefits of weight loss. Moreover, participants explained that they like walking but that sometimes it is difficult to put into practice. Regarding experiences of knee osteoarthritis according Lazarus model: Cognitive evaluation is influenced by cognitive distortions such as obligation, guilt, dramatization and catastrophism. Values: Family is the value most associated with wellbeing. Helping others is another recurring value. Emotions: Most participants explain that they feel anxiety, irritability or sadness. Beliefs: To some, physiotherapy helps them feel less pain. However, others explain that it is of no use to them. Participants are aware of the association overweight– pain. Coping strategies: The strategies for coping with emotions aim to reduce psychological distress (anxiety, sadness, anger) and some are more active than others.ConclusionsThe study highlights that patients with knee osteoarthritis require a person-centered approach that provides them with strategies to overcome the psychological distress caused by this condition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-017-1584-3) contains supplementary material, which is available to authorized users.

Knee Osteoarthritis and Its Related Issues: Patients’ Perspective

“…Only 2 out of the 12 participants reported that knee pain did not affect their emotions. these findings are supported by previous studies in which adults with knee OA usually experience stress, stirred from the unpredictability of symptoms and ineffectiveness of treatment (Carmona et al 2017;Chan et al 2011;Mackay et al 2014). Psychological co-morbidities such as anxiety and depression are highly common among patients with OA and are associated with higher pain and physical limitations (Sharma et al 2016).…”

“…this strategy is commonly used in Asian culture and has been reported previously (Chan et al 2011). In contrast, pain relief strategy reported among westerners consisted of distractions or social support to reduce psychological distress, taking analgesics or exercising to delay worsening of the condition and reducing pain (Carmona et al 2017). the coping method used by our study participants can be considered as a passive approach compared to active ones in western countries.…”

“…Individual burden includes suffering from chronic pain, limitations in daily activities, participation restriction and poor quality of life (hunter et al 2014;Wilkie et al 2007). Both inflammatory and mechanical knee pain due to OA are known to interfere with daily physical function and social activity (Carmona et al 2017;Mackay et al 2014;Alkan et al 2014). Severity of pain can range from barely perceivable to immobilizing (heidari 2011) which further contributes to fatigue, poor mood and reduced quality of sleep (hawker 2009).…”

Design Evaluation of a Novel Multicompartment Unloader Knee Brace

“…Notably, however, overweight or obese individuals who lose !20% of their starting body weight experience the largest clinically relevant benefits [16]. While weight loss can be an effective means for alleviating the symptoms of knee OA, many patients find it difficult to lose weight [21], while others find it difficult to begin exercising due to knee pain, leading to a cycle of further weight gain and increasing joint pain [22].…”

Potential Role of Cost and Quality of Life in Treatment Decisions for Arthritis‐Related Knee Pain in African American and Latina Women

“…The effectiveness of these treatment modalities hinges on the engagement and compliance of the patient with their own treatment. Shared decision‐making is a first step in this engagement . This communication can be enhanced with the use of a shared decision‐making tool .…”