Bunzli, S. (1); O’Brien, P. (1); Ayton, D. (2); Dowsey, M (1); Gunn, J (3); Manski Nankervis (3)
1. The University of Melbourne, Department of Surgery, St Vincent’s Hospital Melbourne, Australia.
2. School of Public Health and Preventative Medicine, Monash University, Australia.
3. Department of General Practice, The University of Melbourne, Australia
Background: In contrast to evidence-based guideline recommendations, uptake of non-surgical interventions for knee osteoarthritis is low. To understand why, we conducted a qualitative investigation involving people with end-stage knee osteoarthritis.
Purpose: The aim of this article is to illustrate the role that illness perceptions played in the uptake of evidence-based care for knee osteoarthritis in this sample.
Method: 27 people awaiting a primary total knee replacement for osteoarthritis participated in semi-structured interviews exploring their perceptions and experiences of seeking care. Interview data were analysed using a two-stage framework approach involving inductive (data derived) coding and deductive coding based on the Common Sense Model of Illness Perceptions. For each of the five belief dimensions described by the model, patterns between participants were identified and described as themes.
Results: Participants believed that their knee osteoarthritis was ‘bone on bone’ (identity beliefs), caused by ‘wear and tear’ (causal beliefs); that loading the knee could further damage their ‘vulnerable’ joint (consequence beliefs) and that their pain would deteriorate over time (timeline beliefs). Participants believed that physiotherapy and exercise interventions would increase pain and could not replace lost knee cartilage, preferring experimental and surgical treatments which they believed would replace lost cartilage and cure their knee pain (treatment beliefs).
Conclusions: Illness perceptions were a key barrier to uptake of evidence-based treatments. By considering how patients make sense of their symptoms and targeting unhelpful beliefs about identity, cause, consequences, timeline and treatment, clinicians may encourage uptake of evidence-based treatments among patients presenting with knee osteoarthritis.
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For more information about this abstract, please contact:
Samantha Bunzli, Department of Surgery, The University of Melbourne and St Vincent’s Hospital Melbourne
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