Browsing by Author "Kania-Richmond, Anna A."

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    Exploring Health Locus of Control and Patient Preferences for the Non-Surgical Management of Osteoarthritis
    (2021-08-09) Kennedy, Bryanne L; Currie, Gillian R.; Marshall, Deborah A.; Emery, Carolyn A.; Kania-Richmond, Anna A.; Gagliardi, Anna R.
    Background:There is no cure for osteoarthritis, and management aims to reduce pain and improve function. Despite guidelines, 61% of people are referred for surgery before trying non-surgical options, and this needs to be further understood. Many factors affect uptake of options, including the osteoarthritis information available to patients. Individual beliefs around who and whatinfluences health, or locus of control, is related to patient preferences for disease management. There is a paucity of literature on locus of control and preferences for osteoarthritis management.Objectives:To identify the factors that patients with hip and knee osteoarthritis consider when choosing management strategies, and to explore their beliefs about who and what influences osteoarthritis symptoms and progression.Methods:Semi-structured interviews with patients who self-reported a diagnosis by a medical professional with hip and/or knee osteoarthritis and had at least one osteoarthritic joint that had not undergone replacement. A multifaceted recruitment approach was used. Interviews were transcribed verbatim and the Braun and Clarke method for thematic analysis was employed.Results:Interviews were conducted with 13 patients from Alberta, Canada. Sixteen factors were identified that participants considered when choosing management strategies. Majority were extrinsic (11), relating to features of programs and services, while five were intrinsic relating to how individual perspectives influence decision making. Three novel factors emerged: 1) whether further management was desired, 2) the prospect of surgery, and 3) participants’ choice inmanagement. Three descriptive themes captured participants’ beliefs about who and what influences their osteoarthritis symptoms and progression: etiology, progression, and symptoms. Most participants believed that others and themselves had some influence over their osteoarthritis symptoms.Conclusions:The findings reinforced that patient’s management decisions for their osteoarthritis were based on the options available to them. This was the first study to explore locus of control in the context of non-surgical osteoarthritis management and provides a point of departure for future work. Factors that patients consider when choosing management strategies were also identifiedthat could be considered for subsequent quantitative research on patient preferences.Keywords: osteoarthritis, internal-external control, patient preference, conservative treatment,disease management, qualitative research