Approaches to osteoarthritis - A qualitative study among patients in a rural setting in Central Western India

Abstract

Background: Osteoarthritis (OA) represents a major cause of disability in India. For implementation of best practice management, it is important to consider the views of people in India since they might deviate from those expressed in previous studies by people with OA in the Western world. Objective: The purpose of this study was to explore and describe approaches toward OA and its management among patients in a rural setting in Central Western India. Design and Method: Conventional content analysis was used to analyze semi-structured interviews with 24 patients diagnosed with OA from the target area of Pravara University Hospital and ten adjacent primary health care centers in Maharashtra, India. Results: Four categories; lack of power, active ambivalence, taking control and a constant struggle were identified as patients' approaches to OA. The categories were further elaborated on in seven subcategories. Conclusion: Daily challenges and efforts, of which some may be unique to patients in a rural setting in India, underlie passive and active approaches to OA and its management. Understanding these may enhance Indian physiotherapists' implementation of evidence-based self-management programs adapted to Indian conditions and reduce the distress of their patients.

Challenges of transforming evidence‐based management of osteoarthritis into clinical practice in rural central Western India. Perceptions of an educational program

“…One hesitation identified in the interviews relates to time constraints. Since the SOASP contradicts Indian patients' expectations of PT management for their OA (Swärdh, Jethliya, et al, 2022) as well as the barriers to implementation of international CPGs in India that were identified in the present results, need to be acknowledged and addressed in the future (Luhar et al, 2020).…”

“…Higher life expectancy and increased prevalence of obesity will increase the prevalence of OA to massive numbers of people affected (Luhar et al., 2020; Wei et al., 2019). We have previously described approaches to OA that may represent barriers to evidence‐based OA management among rural Indian people and PTs in Central Western India (Swärdh et al., 2022a, 2022b). To our knowledge, no formal course on how to implement OA CPGs has been conducted in India or developed for use there.…”

Qualitative evidence synthesis using meta-ethnography to understand the experience of living with osteoarthritis pain

“…17,21,64,67,79,93,114,117,120,137,140,159,164 We included findings from 118 reports (105 unique samples) published between 1998 and 2021. 1–5,7,9–13,15,16,18,20,22–27,31 , 33,34,37,39,40,43-46,48,49 , 52–58,60,61,63,65,66,68–78 , 80-82,86-92,94-101 , 103–105,108–110,112,113,115,118,119 , 121,122,124-130,132-134,141-147 , 149–155,158,160–162,165–169 Table 2 presents the author, year of publication, country, condition, number of participants, and age. Most studies explored the experience of knee and hip osteoarthritis, and 30 of these specifically aimed to understand decision-making for hip or knee joint replacement surgery.…”

Effects of Hot Packs on pain in patients with Osteoarthritis (OA) in Saidu Group of Teaching Hospital Swat: A Randomized Control Trial

“…While age and general health are taken into account when deciding on a conservative treatment plan, most patients do not consent to surgical intervention. 7 According to research conducted by Swärdh et al, 8 in the year 2021, applying a hot pack can help alleviate discomfort and swelling in a variety of different types of muscles and joints. There is some debate as to whether or not cold packs should be used during the winter to reduce swelling and pain.…”

“…Based on the results of this study, applying a hot pack is a viable and effective therapy option for persons of all ages suffering from osteoarthritis, especially those who are unwilling to undergo surgery. 8 In 2021, researchers compared the efficacy of a cold rub gel for pain management and joint function in individuals with knee osteoarthritis to that of a local heat treatment. Findings indicated that both heat and cold therapy improved joint function and pain relief.…”