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Navigating the maze of osteoarthritis treatment: A qualitative study exploring the experience of individuals with osteoarthritis in Tasmania, Australia

机译:驾驭骨关节炎治疗的迷宫:一项探索澳大利亚塔斯马尼亚州骨关节炎患者经历的定性研究

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Abstract Objective Using a qualitative design this study aimed to (1) explore the experience of people living with osteoarthritis (OA), (2) gain an understanding of their navigation of the health system and, (3) explore their opinions on the role of exercise and joint replacement surgery for the management of OA. Methods Purposive sampling was used to recruit 26 participants with knee OA, aged 45?years and over, from Tasmania, Australia. Semi‐structured interviews were audio‐recorded, transcribed, coded, and thematically analysed to document participant understanding and experience of OA and their opinions on the role of exercise and surgery in managing OA. Results Of the 26 participants, 80 (n?=?21) were female with a mean age of 66?years. The main theme identified was that individuals with knee OA were navigating a maze of OA treatments. Three related subthemes were that participants: (i) perceived their general practitioner did not have an ongoing role in their OA care, (ii) self‐directed their management and, (iii) sampled from a ‘smorgasbord’ of treatment options, including low‐value care options. Two other major themes were: the role of exercise for OA management, and surgery as a last resort. Conclusion Our findings suggest that OA patients may not be choosing consistent, high‐value care for their OA. This highlights the importance of an evidence‐based multi‐disciplinary approach to guide patients to self‐manage their OA and support their navigation of the health system. Reducing emphasis on the pathway to surgery and streamlining access to conservative management strategies may assist people to receive high‐value care.
机译:摘要 目的 本研究采用定性设计,旨在(1)探讨骨关节炎(OA)患者的经历,(2)了解他们对卫生系统的导航,(3)探讨他们对运动和关节置换手术在OA管理中的作用的看法。方法 采用目的抽样方法,选取澳大利亚塔斯马尼亚州26例45岁及以上的膝关节OA患者。对半结构化访谈进行录音、转录、编码和主题分析,以记录参与者对 OA 的理解和体验,以及他们对运动和手术在管理 OA 中的作用的看法。结果 26例患者中,女性占80%(n?=?21),平均年龄66岁。确定的主题是膝关节 OA 患者正在迷宫般的 OA 治疗中导航。三个相关的子主题是参与者:(i)认为他们的全科医生在他们的OA护理中没有持续的作用,(ii)自我指导他们的管理,以及(iii)从治疗方案的“大杂烩”中抽样,包括低价值的护理方案。另外两个主要主题是:运动对OA管理的作用,以及手术作为最后的手段。结论 我们的研究结果表明,OA患者可能没有为他们的OA选择一致的、高价值的护理。这凸显了基于证据的多学科方法的重要性,以指导患者自我管理他们的 OA 并支持他们在卫生系统中的导航。减少对手术途径的重视,简化保守治疗策略的可及性,可能有助于患者获得高价值的护理。

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