Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

Patient information and emotional needs across the hip osteoarthritis continuum: a qualitative study

Authors: Espen Andreas Brembo, Heidi Kapstad, Tom Eide, Lukas Månsson, Sandra Van Dulmen, Hilde Eide

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

Osteoarthritis (OA) is the most common form of arthritis worldwide, affecting a growing number of people in the ageing populations. Currently, it affects about 50 % of all people over 65 years of age. There are no disease-modifying treatments for OA; hence preference-sensitive treatment options include symptom reduction, self-management and surgical joint replacement for suitable individuals. People have both ethical and legal rights to be informed about treatment choices and to actively participate in decision-making. Individuals have different needs; they differ in their ability to understand and make use of the provided information and to sustain behaviour change-dependent treatments over time.

Methods

As a part of a larger research project that aims to develop and test a web-based support tool for patients with hip OA, this paper is a qualitative in-depth study to investigate patients’ need for information and their personal emotional needs. We invited 13 patients to participate in individual interviews, which were audiotaped. The audio-tapes were transcribed verbatim and analysed using an inductive thematic analysis approach.

Results

The thematic analysis revealed a pattern of patients’ information and emotional needs, captured in several key questions relevant to the different stages of the disease experience. Based on these results and research literature, we developed a model illustrating the patients' disease experience and treatment continuum. Six phases with accompanying key questions were identified, displaying how patients information and emotional needs arise and change in line with the progression of the disease experience, the clinical encounters and the decision-making process. We also identified and included in the model an alternative route that bypasses the surgical treatment option.

Conclusion

Patients with hip OA are in great need of information both at the time of diagnosis and further throughout the disease development and care continuum. Lack of information may result in unnecessary and dysfunctional misconceptions, underuse of potentially helpful treatment options and uninformed decisions. Patients need continuous support from health professionals and their families in order to find and consider effective treatment strategies.
Literature
1.
Neogi T, Zhang Y. Epidemiology of osteoarthritis. Rheum Dis Clin N Am. 2013;39(1):1–19.CrossRef
2.
Jordan JM, Helmick CG, Renner JB, Luta G, Dragomir AD, Woodard J, Fang F, Schwartz TA, Nelson AE, Abbate LM et al: Prevalence of hip symptoms and radiographic and symptomatic hip osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project. J Rheumatol. 2009;36(4):809–15.
3.
Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK. Prevalence and burden of osteoarthritis: results from a population survey in Norway. J Rheumatol. 2008;35(4):677–84.PubMed
4.
Busija L, Bridgett L, Williams SRM, Osborne RH, Buchbinder R, March L, Fransen M. Osteoarthritis. Best Pract Res Clin Rheumatol. 2010;24(6):757–68.
5.
Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan P. Living with osteoarthritis: a systematic review and meta-ethnography. Scandinavian Journal of Rheumatology 2014;43(6):441-52.
6.
7.
Ballantyne PJ, Gignac MAM, Hawker GA. A patient-centered perspective on surgery avoidance for hip or knee arthritis: Lessons for the future. Arthritis Rheum. 2007;57(1):27–34.CrossRefPubMed
8.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, Bierma-Zeinstra S, Brandt KD, Croft P, Doherty M et al: OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil. 2008;16(2):137–62.
9.
Paans N, van der Veen WJ, van der Meer K, Bulstra SK, van den Akker-Scheek I, Stevens M. Time spent in primary care for hip osteoarthritis patients once the diagnosis is set: a prospective observational study. BMC Fam Pract. 2011;12:48.CrossRefPubMedPubMedCentral
10.
Hampson SE, Glasgow RE, Zeiss AM. Personal models of osteoarthritis and their relation to self-management activities and quality of life. J Behav Med. 1994;17(2):143–58.CrossRefPubMed
11.
Golightly YM, Allen KD, Caine DJ. A comprehensive review of the effectiveness of different exercise programs for patients with osteoarthritis. Phys Sportsmed. 2012;40(4):52–65.CrossRefPubMedPubMedCentral
12.
Campbell R, Evans M, Tucker M, Quilty B, Dieppe P, Donovan JL. Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee. J Epidemiol Community Health. 2001;55(2):132–8.CrossRefPubMedPubMedCentral
13.
Austin S, Qu H, Shewchuk R. Association between adherence to physical activity guidelines and health-related quality of life among individuals with physician-diagnosed arthritis. Qual Life Res. 2012;21(8):1347–57.CrossRefPubMed
14.
Turner AP, Barlow JH, Buszewicz M, Atkinson A, Rait G. Beliefs about the causes of osteoarthritis among primary care patients. Arthritis Rheum. 2007;57(2):267–71.CrossRefPubMed
15.
Sale JEM, Gignac M, Hawker G. How “bad” does the pain have to be? A qualitative study examining adherence to pain medication in older adults with osteoarthritis. Arthritis Rheum. 2006;55(2):272–8.CrossRefPubMed
16.
Alami S, Boutron I, Desjeux D, Hirschhorn M, Meric G, Rannou F, Poiraudeau S. Patients' and practitioners' views of knee osteoarthritis and its management: a qualitative interview study. PLoS One. 2011;6(5):e19634.CrossRefPubMedPubMedCentral
17.
18.
Hamel M, Toth M, Legedza A, Rosen MP. Joint replacement surgery in elderly patients with severe osteoarthritis of the hip or knee: Decision making, postoperative recovery, and clinical outcomes. Arch Intern Med. 2008;168(13):1430–40.CrossRefPubMed
19.
20.
21.
NRL. Rapport Juni 2014. In: Nasjonal kompetansetjeneste for leddproteser og hoftebrudd. Helse-Bergen: Ortopedisk klinikk; 2014.
22.
Shan L, Shan B, Graham D, Saxena A. Total hip replacement: a systematic review and meta-analysis on mid-term quality of life. Osteoarthr Cartil. 2014;22(3):389–406.CrossRefPubMed
23.
Arden NK, Kiran A, Judge A, Biant LC, Javaid MK, Murray DW, Carr AJ, Cooper C, Field RE: What is a good patient reported outcome after total hip replacement? Osteoarthr Cartil. 2011;19(2):155–62.
24.
Anakwe R, Jenkins P, Moran M. Predicting dissatisfaction after total hip arthroplasty: a study of 850 patients. J Arthroplasty. 2011;26(2):209–13.CrossRefPubMed
25.
Mäkelä KT, Matilainen M, Pulkkinen P, Fenstad AM, Havelin LI, Engesaeter L, Furnes O, Overgaard S, Pedersen AB, Kärrholm J et al: Countrywise results of total hip replacement. Acta Orthop. 2014;85(2):107–16.
26.
27.
Hawker GA, Badley EM, Borkhoff CM, Croxford R, Davis AM, Dunn S, Gignac MA, Jaglal SB, Kreder HJ, Sale JE: Which patients are most likely to benefit from total joint arthroplasty? Arthritis Rheum. 2013;65(5):1243–52.
28.
Montin L, Leino-Kilpi H, Suominen T, Lepistö J. A systematic review of empirical studies between 1966 and 2005 of patient outcomes of total hip arthroplasty and related factors. J Clin Nurs. 2008;17(1):40–5.CrossRefPubMed
29.
Fortin P, Clarke A, Joseph L, Liang M, Tanzer M, Ferland D, Phillips C, Partridge A, Belisle P, Fossel A et al: Outcomes of total hip and knee replacement: preoperative functional status predicts outcomes at six months after surgery. Arthritis Rheum. 1999;42(8):1722–8.
30.
Fortin PR, Penrod JR, Clarke AE, St-Pierre Y, Joseph L, Belisle P, Liang MH, Ferland D, Phillips CB, Mahomed N et al: Timing of total joint replacement affects clinical outcomes among patients with osteoarthritis of the hip or knee. Arthritis Rheum. 2002;46(12):3327–30.
31.
Webster F, Perruccio AV, Jenkinson R, Jaglal S, Schemitsch E, Waddell JP, Bremner S, Mobilio MH, Venkataramanan V, Davis AM. Where is the patient in models of patient-centred care: a grounded theory study of total joint replacement patients. BMC Health Services Research 2013;13(1):1-8.
32.
33.
34.
Braun V, Clarke V. Successful qualitative research : a practical guide for beginners. Los Angeles: Sage; 2013.
35.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
36.
37.
38.
DeSantis L, Ugarriza DN. The concept of theme as used in qualitative nursing research. West J Nurs Res. 2000;22(3):351–72.CrossRefPubMed
39.
Dieppe P, Doherty M. Contextualizing osteoarthritis care and the reasons for the gap between evidence and practice. Clin Geriatr Med. 2010;26(3):419–31.CrossRefPubMed
40.
Cuperus N, Smink AJ, Bierma-Zeinstra SMA, Dekker J, Schers HJ, de Boer F, van den Ende CH, Vliet Vlieland TPM: Patient reported barriers and facilitators to using a self-management booklet for hip and knee osteoarthritis in primary care: results of a qualitative interview study. BMC Fam Pract. 2013;14:181–1.
41.
Sanders C, Donovan JL, Dieppe PA. Unmet need for joint replacement: a qualitative investigation of barriers to treatment among individuals with severe pain and disability of the hip and knee. Rheumatology (Oxford). 2004;43(3):353–7.CrossRef
42.
Hill J, Bird H. Patient knowledge and misconceptions of osteoarthritis assessed by a validated self-completed knowledge questionnaire (PKQ-OA). Rheumatology (Oxford). 2007;46(5):796–800.CrossRef
43.
Gronhaug G, Osteras N, Hagen KB. Quality of hip and knee osteoarthritis management in primary health care in a Norwegian county: a cross-sectional survey. BMC Health Serv Res. 2014;14:598.CrossRefPubMedPubMedCentral
44.
French SD, Bennell KL, Nicolson PJ, Hodges PW, Dobson FL, Hinman RS. What do people with knee or hip osteoarthritis need to know? An international consensus list of essential statements for osteoarthritis. Arthritis Care Res (Hoboken). 2015;67(6):809–16.CrossRef
45.
Scott C, Bugler K, Clement N, Macdonald D, Howie C, Biant L. Patient expectations of arthroplasty of the hip and knee. J Bone Joint Surg (Br). 2012;94(7):974–81.CrossRef
46.
Hudak PL, Armstrong K, Braddock C, Frankel RM, Levinson W. Older patients' unexpressed concerns about orthopaedic surgery. J Bone Joint Surg Am. 2008;90(7):1427–35.CrossRefPubMedPubMedCentral
47.
48.
Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Soc Sci Med. 1997;44(5):681–92.CrossRefPubMed
49.
Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA. 1992;267(16):2221–6.CrossRefPubMed
Metadata
Title
Patient information and emotional needs across the hip osteoarthritis continuum: a qualitative study
Authors
Espen Andreas Brembo
Heidi Kapstad
Tom Eide
Lukas Månsson
Sandra Van Dulmen
Hilde Eide
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1342-5

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue

Research article

Burden of socio-legal concerns among vulnerable patients seeking cancer care services at an urban safety-net hospital: a cross-sectional survey

Research article

Availability and utilization of medical devices in Jimma zone hospitals, Southwest Ethiopia: a case study

Research article

Affordable care act: comparison of healthcare indicators among different insurance beneficiaries with new coverage eligibility

Research article

Advancing scoping study methodology: a web-based survey and consultation of perceptions on terminology, definition and methodological steps

Research article

Investigating the feasibility, acceptability and appropriateness of outreach case management in an urban Aboriginal and Torres Strait Islander primary health care service: a mixed methods exploratory study

Research article

Circle of care modelling: an approach to assist in reasoning about healthcare change using a patient-centric system