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患者对改善城乡社区骨关节炎管理的看法。

Patient perspectives on improving osteoarthritis management in urban and rural communities.

作者信息

Ali Shabana Amanda, Walsh Kathleen Ellen, Kloseck Marita

机构信息

Faculty of Health Sciences, University of Western Ontario, London, ON.

Faculty of Science, University of Western Ontario, London, ON, Canada.

出版信息

J Pain Res. 2018 Feb 22;11:417-425. doi: 10.2147/JPR.S150578. eCollection 2018.

Abstract

INTRODUCTION

Although there is no cure for osteoarthritis (OA), there are lifestyle modifications that can mitigate symptoms such as pain, and improve management of the disease. This information is not always translated to community-dwelling seniors. Individuals in rural areas often face additional challenges due to geographic isolation and decreased access to community services.

METHODS

We used qualitative research methodology (hermeneutic phenomenology) to better understand the lived experiences of urban and rural community-dwelling seniors diagnosed with OA. We explored their sources of information about OA, how they manage their OA pain, and how OA management could be improved in the community. Purposeful sampling was used to recruit 20 information-rich participants (11 urban, 9 rural) in Ontario, Canada. All participants were aged >65 and diagnosed with OA. Semi-structured interviews were conducted, audio recorded, and transcribed verbatim. NVivo 11 Pro qualitative software was used to code transcripts.

RESULTS

Thematic analysis revealed 9 key themes where 8 were common to urban and rural participants, and 1 was unique to rural participants. Most significant among the common themes was the description of the social network as a source of OA information, the trial-and-error approach used for OA management, and the individual contextualization of OA management. Our results suggest that there are several common experiences among urban- and rural-dwelling seniors living with OA, including the desire for support over time, but also a unique experience to rural-dwelling seniors, namely lack of access to local care.

CONCLUSION

These findings can be used to improve translation of OA information in both urban and rural communities in Canada, highlighting that common strategies may be effective in different contexts for this disease.

摘要

引言

尽管骨关节炎(OA)无法治愈,但可以通过改变生活方式来缓解疼痛等症状,并改善疾病管理。然而,这些信息并未总是传达给居住在社区的老年人。农村地区的居民由于地理隔离和社区服务获取机会减少,往往面临更多挑战。

方法

我们采用定性研究方法(诠释现象学),以更好地了解被诊断为OA的城市和农村社区居住老年人的生活经历。我们探讨了他们关于OA的信息来源、如何管理OA疼痛以及如何在社区中改善OA管理。采用目的抽样法在加拿大安大略省招募了20名信息丰富的参与者(11名城市居民,9名农村居民)。所有参与者年龄均超过65岁且被诊断为OA。进行了半结构化访谈,录音并逐字转录。使用NVivo 11 Pro定性软件对转录本进行编码。

结果

主题分析揭示了9个关键主题,其中8个是城市和农村参与者共有的,1个是农村参与者独有的。在共同主题中,最重要的是将社交网络描述为OA信息来源、用于OA管理的试错方法以及OA管理的个体情境化。我们的结果表明,患有OA的城市和农村居住老年人有一些共同经历,包括长期对支持的渴望,但农村居住老年人也有独特经历,即难以获得当地护理。

结论

这些发现可用于改善加拿大城市和农村社区OA信息的传播,强调常见策略在这种疾病的不同背景下可能有效。

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