Sam Katz Community Health and Aging Research Unit, Faculty of Health Sciences, Western University, Arthur & Sonia Labatt Health Sciences Building, Room 316, 1151 Richmond Street, London, ON, N6A 5B9, Canada.
J Community Health. 2018 Aug;43(4):816-826. doi: 10.1007/s10900-018-0470-8.
With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding. A full scoping review was conducted across five databases resulting in 656 abstracts screened. All text was coded using the categorization matrix and resulting subthemes were identified. A total of 74 articles were analyzed with 23 subthemes identified across the nine categories. Four new perspectives emerged to support OA care for Asian populations: (1) the importance of family and peer assistance, (2) the importance of culturally specific activities, (3) distrust in western medicine, and (4) impact of positive coping mechanisms on health appraisals. While Asians are more susceptible to knee and hand OA because of their cultural lifestyle factors (e.g. squatting for chores, hygiene and religious activities), and traditional beliefs on OA management (e.g. traditional diet, topical oils, physical therapy), many do not present themselves for conventional treatments (e.g. surgery) until all traditional treatments are exhausted. The results suggest that cultural factors influence the uptake of OA management practices among Asians. Greater awareness of these cultural factors may improve diagnosis, treatment, and management of OA among Asian patients.
随着骨关节炎（OA）在国际上的患病率不断上升，有必要研究这种疾病对不同文化人群的影响。亚洲人占世界人口的 60%以上，但关于影响 OA 护理的文化因素的综合信息尚不可用。采用定向内容分析法的范围综述方法，旨在确定和分析针对亚洲人的 OA 护理现有研究。使用 OA 临床实践指南中的六个护理领域以及初始扫描中确定的另外三个非临床领域（临床工具的跨文化适应；心理幸福感；家庭系统和非正式护理）开发了分类矩阵，总共九个 OA 护理领域指导初始编码。在五个数据库中进行了全面的范围综述，共筛选出 656 篇摘要。使用分类矩阵对所有文本进行编码，并确定了次要主题。共分析了 74 篇文章，在九个类别中确定了 23 个次要主题。有四个新观点出现，以支持亚洲人群的 OA 护理：（1）家庭和同伴协助的重要性，（2）特定文化活动的重要性，（3）对西医的不信任，以及（4）积极应对机制对健康评估的影响。虽然亚洲人由于文化生活方式因素（例如蹲伏做家务、卫生和宗教活动）和传统的 OA 管理观念（例如传统饮食、局部油、物理疗法）更容易患上膝和手部 OA，但许多人不会出现传统治疗（例如手术），直到所有传统治疗都用尽。结果表明，文化因素影响亚洲人对 OA 管理实践的接受程度。更多地了解这些文化因素可能会改善亚洲患者的 OA 诊断、治疗和管理。
