Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka.
BMC Musculoskelet Disord. 2021 Apr 9;22(1):341. doi: 10.1186/s12891-021-04190-z.
Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ.
We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2020) systematically to identify non-healthcare-related needs of people with IA or OA. All citations were screened and quality appraised by two reviewers. Data was extracted by a single reviewer.
The search identified 7853 citations, with 31 studies included (12 for OA, 20 for IA). Six areas of need emerged and these were similar in both group These were: 1) Assistance with activities of daily living especially related to a lack of independence; 2) Social connectedness: need for social participation; 3) Financial security: worry about financial security and increased costs of health-seeking behaviours; 4) Occupational needs: desire to continue work for financial and social reasons, facilitated by flexibility of workplace conditions/environment; 5) Exercise and leisure: including limitation due to pain; 6) Transportation: limitations in ability to drive and take public transport due to mobility concerns. Many areas of need were linked; e.g. loss of employment and requiring support from family was associated with a sense of "failure" and loss of identity, as social isolation.
This review highlights the pervasive impact of arthritis on peoples' lives, regardless of aetiology, albeit with a limited evidence base. Improved identification and targeting of non-healthcare needs of people with arthritis is likely to improve person-centred care.
无论病因如何,关节炎都会对患者的身体、社交和心理造成重大影响。我们旨在确定炎症性关节炎(IA)和骨关节炎(OA)患者所感知的非医疗保健需求,并确定这些需求是否存在差异。
我们系统地在 MEDLINE、PsycINFO、EMBASE 和 CINAHL(1990-2020 年)上进行电子检索,以确定患有 IA 或 OA 的人群的非医疗保健相关需求。两位评审员筛选了所有引文并进行了质量评估。一位评审员提取了数据。
搜索共确定了 7853 条引文,其中包括 31 项研究(12 项针对 OA,20 项针对 IA)。出现了 6 个需求领域,这两个组的需求相似,包括:1)日常生活活动的协助,特别是与缺乏独立性有关的活动;2)社会联系:需要社会参与;3)财务安全:担心财务安全和增加健康寻求行为的成本;4)职业需求:出于财务和社会原因希望继续工作,工作场所条件/环境的灵活性有助于实现这一目标;5)运动和休闲:包括因疼痛而受限;6)交通:由于行动不便,驾驶和乘坐公共交通工具的能力受限。许多需求领域相互关联;例如,失业和需要家人支持与“失败”和身份丧失感有关,这会导致社交孤立。
本综述强调了关节炎对人们生活的普遍影响,无论病因如何,但证据基础有限。改善对关节炎患者非医疗保健需求的识别和针对性,可能会改善以患者为中心的护理。