Patients' Perceptions of Navigating “The System” for Arthritis Management: Are They Able to Follow Our Recommendations?

Abstract

Purpose: To understand whether a visit to a Hip/Knee Arthritis Assessment Centre (AC), where non-surgical candidates with arthritis are directed toward community resources and provided with a conservative treatment ''prescription,'' contributes to patients' self-management and ability to access community resources. Methods: A purposive sample of non-surgical patients was contacted 3-10 months after their AC visit. Three focus groups (n ¼ 20) and 20 semi-structured telephone interviews were conducted. Transcripts were systematically coded and analyzed using a qualitative descriptive research methodology. Results: While participants generally reported that the AC visit improved self-management, analysis identified an emergent theme about the inadequacy of conservative management in general, subdivided into two sub-themes related to (1) limited access to high-quality, non-surgical treatment, such as physiotherapy and (2) health care providers' attitudes and approaches, which do not embrace chronic disease prevention and management. Conclusions: An AC visit contributes to arthritis self-management; however, the current health care system does not adequately support conservative treatment of chronic conditions. Treatment guidelines need to be tailored to the local health care context in which they are applied.Key Words: disease management; health services accessibility; osteoarthritis; survey. RÉ SUMÉObjectif: Pour comprendre si une visite à un centre d'é valuation de l'arthrite de la hanche ou du genou, où des personnes qui ne sont pas candidates a grave; une intervention chirurgicale et ont de l'arthrite sont dirigé es vers des ressources communautaires et reç oivent une « ordonnance » portant sur un traitement de conservation, contribue à l'autoprise en charge par les patients et à leur capacité d'avoir accè s aux ressources communautaires. Mé thodes: On a communiqué , pendant 3 à 10 mois aprè s leur visite au centre d'é valuation, avec un é chantillon choisi à dessein de patients non candidats à une intervention chirurgicale. On a organisé trois groupes de discussion (n ¼ 20) et procé dé à 20 entrevues té lé phoniques semi structuré es. Les comptes rendus ont é té codé s systé matiquement et analysé s au moyen d'une mé thodologie de recherche descriptive qualitative. Ré sultats: Les participants ont signalé en gé né ral que les visites au centre d'é valuation amé lioraient l'autoprise en charge, mais l'analyse a dé gagé un thè me é mergent au sujet de l'insuffisance de la prise en charge conservatrice en gé né ral, subdivisé en deux sous-thè mes portant sur (1) l'accè s limité à un traitement non chirurgical de grande qualité comme la physiothé rapie et (2) les attitudes et les approches des fournisseurs de soins de santé qui n'adoptent pas la pré vention et la prise en charge des maladies chroniques. Conclusions: Une visite à un centre d'é valuation contribue à l'autoprise en charge de l'arthrite, mais le systè me de santé actuel n'appuie pas adé quatement un traitement conservateur des problè mes chroni...

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