A study on the experience of living with knee osteoarthritis
Pouli N, das Nair R, Lincoln NB and Walsh DA. The experience of living with knee osteoarthritis: exploring illness and treatment beliefs through thematic analysis. Disability & Rehabilitation. Apr 2014, Vol. 36, No. 7, Pages 600-607.
Background
Knee osteoarthritis is one of the most common types of arthritis, causing pain, disability as well as emotional distress. However, there is limited research on the daily experience of living with knee OA. Understanding people's beliefs and how they can affect the outcome of treatment recommendations should help healthcare professionals to provide information and education that will assist people in managing osteoarthritis.
Aim
The aim of the study was to explore participants' experience of living with knee OA and their beliefs about knee OA and its treatment.
How the study was carried out
Twenty four interviews were conducted with 17 women and 7 men with physician-diagnosed knee OA, aged between 48 and 84 years. The audio-taped interviews lasted from 30 minutes to one hour.
What the study found
Even though the intensity of reported pain differed between participants, the majority placed pain at the core of their experience. Many participants reported being always aware of the pain and presented it as something that never goes away, while they viewed their illness as progressively deteriorating. The majority of participants reported that they relied on medical control of pain but most participants described partial pain relief, with medication 'numbing the pain'. Participants also presented a wide range of beliefs about the possible causes of knee OA. Some accounts were focused on placing responsibility on the individual, such as the impact of previous activities or excessive body weight that could have been avoided, while others attributed causes to factors beyond the individual's control, such as genes, weather, trauma, or ageing.
Participants reported several beliefs about the impact of medication, and a sense of ambivalence towards relying on 'pills' for pain relief. They expressed concerns about the side-effects of some medication and a worry about becoming dependent. At the same time, participants tended to express a desire to lower the dosage of pain killers or find alternative ways to control pain. Participants also considered the impact of knee replacement surgery, and for some the prospect of a knee operation offered them a sense of hope. However, many participants were not in favour of knee replacement surgery, either because they had heard stories of unsuccessful replacements or because they viewed the operation as compromising the sense of personal control.
Significance of the study to arthritis research
People with knee OA place pain at the core of their living, and hold beliefs about knee OA being an incurable disease of a progressive nature, linked to specific causal factors. They also have concerns and worries about use of medication to control pain, and are ambivalent towards relying on medical or surgical interventions.
In this study it was evident that patients hold their own views about the effectiveness of medication and many expressed worries and fears about drug dependency. Healthcare professionals should strive to better address unjustified fears, while more research is needed to address realistic concerns of people with OA.