“Somebody to Say ‘Come On We Can Sort This’”: A Qualitative Study of Primary Care Consultation Among Older Adults With Symptomatic Foot Osteoarthritis

Abstract

ObjectiveTo examine the experiences of primary care consultation among older adults with symptomatic foot osteoarthritis (OA).MethodsEleven participants (6 women and 5 men) ages 56–80 years who had radiographically confirmed symptomatic foot OA and consulted a general practitioner in the last 12 months for foot pain were purposively sampled. Semistructured interviews explored the nature of the foot problem, help-seeking behaviors, and consultation experiences. Verbatim transcripts were analyzed using interpretative phenomenological analysis.ResultsThe decision to consult a physician was often the outcome of a complex process influenced by quantitative and qualitative changes in symptoms, difficulty maintaining day-to-day roles and responsibilities and the effect this had on family and work colleagues, and a reluctance to present a fragile or aging self to the outside world. Self-management was commonly negotiated alongside multimorbidities. Upon seeking help, participants often believed they received limited information, they were given a brief or even cursory assessment, and that treatment was focused on the prescription of analgesic drugs.ConclusionThis is the first qualitative study of primary care experiences among patients with symptomatic foot OA. The experience of primary care seldom appeared to move beyond a label of arthritis and an unwelcome emphasis on pharmacologic treatment.

Footwear Experiences of People With Chronic Musculoskeletal Diseases

“…We can postulate that women from the general population may be willing to persevere with fashionable but ill‐fitting footwear that may be causing some mild foot pain, whereas women who have disease‐related foot pain and/or deformities may be less resilient or less willing to persist with such footwear due to the potential for increased levels of foot pain and discomfort. These findings are reflective of past studies of people with RA and OA, suggesting that body image is an important factor in relation to perceptions of appropriate footwear . In contrast, a recent study of footwear choices in a predominantly male cohort with gout found that footwear choices were driven more by comfort, fit, and support .…”

“…A qualitative study of symptomatic foot OA has recently highlighted the importance of suitable footwear for female OA patients . In particular, women expressed that footwear and personal appearance were important elements of desirable self‐image, arguably similar to previous findings from studies of women with RA .…”

“…These data largely corroborate previous findings with regard to the footwear experiences of people with RA , but also provide new and novel findings concerning the experiences of those with other less frequently researched conditions in the context of footwear issues, particularly OA, SLE, gout, and SSc. Interestingly, the results indicate that some footwear difficulties previously reported for people with RA appear to also be similarly experienced by people who have other chronic musculoskeletal diseases . Therefore, this study has been successful in achieving its aims through the use of content analysis by generating a broad description of the phenomenon of footwear experiences in this sample population, where such information was previously limited .…”

Factors influencing the implementation of evidence‐based guidelines for osteoarthritis in primary care: A systematic review and thematic synthesis

“…Egerton et al () (Egerton et al, ) and many others have reported the perception that ‘OA is not that serious’ and that ‘personal beliefs are at odds with providing recommended practice’. A body of literature suggests that OA is a low priority to both HCPs and patients, and, that HCPs' personal beliefs do not always align with recommended guidelines (Egerton et al, , Paskins, Sanders, & Hassell, , Paskins, Sanders, & Hassell, , Thomas, Moore, Roddy, & Peat, , Jinks, Ong, & Richardson, ). In addition, findings illustrated how self‐management was not viewed as core business by some GPs and because the condition didn't align to pay‐for‐performance targets, and implementation was reported not to provide any benefits to the practice.…”

The prevalence of pain and its relationship to falls, fatigue, and depression in a cohort of older people living in the community

“…Although reluctant to seek medical advice the older people wanted support and information on which to base their decisions on how to manage the pain. Older people are often reluctant to present a fragile or ageing self to others (Thomas, Moore, Roddy, & Peat, ) so nurses need to provide support that challenges this stereotype and promotes optimal functioning to improve their quality of life.…”