Patient beliefs about who and what influences their hip and knee osteoarthritis symptoms and progression

Abstract

Background: Osteoarthritis management aims to reduce pain and improve function. Many factors affect whether patients follow recommended strategies. Locus of control refers to individual beliefs around who and what influences health. Locus of control is related to the treatment strategies patients prefer. Currently, no studies explore locus of control in non-surgical management of osteoarthritis. Objectives: To explore patients' beliefs about the influences on their osteoarthritis symptoms and disease progression.Methods: Semi-structured interviews were conducted with individuals experiencing self-reported hip and/or knee osteoarthritis who had at least one joint that had not undergone replacement surgery. We used a qualitative description approach and the Braun and Clarke method for thematic analysis. Participants' locus of control classifications-internal, chance, doctors, or other people-were based on the Multidimensional Health Locus of Control (MHLC) Scales Form C score.Results: Locus of control was discussed in relation to aetiology, progression, and symptoms. Participants' opinions varied on whether their osteoarthritis progression could be influenced. 46% of participants attributed control to other people. Most participants believed that a previous injury had caused their osteoarthritis and that both themselves and others had some influence over their osteoarthritis symptoms, regardless of their locus of control classification. Conclusion:This research highlights the need for education about: the aetiology of osteoarthritis, the link between management and progression, and patient management of osteoarthritis. Further research is required to discern why expected patterns were not observed between participants' beliefs and locus of control classifications.

From sceptic to believer: Acceptability of cognitive muscular therapyTM, a new intervention for knee osteoarthritis

“…Our findings support and confirm previous research into the beliefs held by patients and physiotherapists regarding knee OA progression (Bunzli et al., 2019; Kennedy et al., 2022; Wallis et al., 2019). We found that patients and physiotherapists view OA as a wear and tear disease that affects the quality of life and is likely to require surgical input.…”

“…As such, although motivated to engage with health professionals, patients felt a lack of confidence in managing their condition. Moreover, due to commonly held beliefs about exercise causing harm (Bunzli et al., 2019; Kennedy et al., 2022), the patients had previously found engaging in exercise a challenge. In turn, the physiotherapists felt that their current practices were not meeting the needs of all patients, and they were not able to consistently influence the patient's outcomes.…”

Peoples' beliefs about their chronic hip pain and its care: a systematic review of qualitative studies. “I'm just getting old and breaking down”

“…This finding is consistent with past qualitative research of people with back and knee pain. 17,29,67,112 Thus, our review findings strengthen calls for better shared decision making between health professionals and patients. 20,76,123,101 People with hip pain wanted more information about what treatments were available to them and about the treatments offered to them.…”

“…People may have missed opportunities to improve their hip pain and health by avoiding exercise and physical activity; both are recommended treatments for hip pain. 6,64,67,71,85 Social isolation and physical inactivity can also worsen hip pain and magnify its negative impacts. 63,99 Our findings underscore the need for health professionals to explore the emotional and social needs of people living with chronic hip pain.…”

The Effect of Telerehabilitation-Based Exercise and Education on Pain, Function, Strength, Proprioception and Psychosocial Parameters in Patients with Knee Osteoarthritis

“…Poor patient compliance with rehabilitation programs reduces the effectiveness of treatment in individuals with OA. Major barriers to continuity in rehabilitation programs include inappropriate timing, transportation problems, economic inadequacy, and lack of perceived benefit 4 …”