Mathieu Sylvain, Courties Alice, Mathy Céline, Perrot Serge, Launois Françoise Alliot, Moumbe Stanislas, Foulquier Nathan, Sellam Jérémie, Geenen Rinie
Department of Rheumatology, Hôpital Gabriel Montpied, 63000 Clermont-Ferrand, France.
Insrm U-1107, NeuroDol, Clermont-Ferrand, France.
Osteoarthr Cartil Open. 2025 Feb 25;7(2):100590. doi: 10.1016/j.ocarto.2025.100590. eCollection 2025 Jun.
To enable person-centered care, considering beliefs, needs, and priorities of individuals with osteoarthritis (OA) is crucial. Nevertheless, concepts that they consider important are not fully recapitulated in assessment and care. The aim of this study was to clarify how individuals with OA conceive, experience, and manage their OA and pain.
A systematic literature review was conducted including qualitative studies (interviews, focus groups, open questionnaires) regardless of OA joint location. Verbatim quotations relating to OA and OA-related pain were collected and merged in codes. Themes and categories relating to these codes were defined.
The seven databases yielded a total of 9585 studies of which 79 qualitative studies were selected. Analysis of 667 verbatim quotations of 2009 participants led to 117 codes and 24 themes. Themes were grouped into 2 categories, 'features' and 'management'. 'Features' encompassed experiences ranging from common challenges (e.g., adjust to reduced function) to high impact outcomes needing therapeutic attention (e.g., devastating pain). The 'management' category captured positive and negative conceptions associated with pharmacological and cognitive-behavioral self-management, psychoeducation, and interventions. Themes from both categories were classified into four domains: symptoms, functioning, psychological, and social. A fifth domain 'disease' was also used to categorize the themes under 'features'.
Several themes reported by OA individuals are hardly represented in current assessment and recommendations, e.g., fatigue, sleep disturbance, psychosocial impact, and effects on family and caregivers. The reviewed beliefs, needs, and priorities may support individualized screening, complement existing assessment instruments, and can help refine interventions and psychoeducational materials.
要实现以患者为中心的护理，考虑骨关节炎（OA）患者的信念、需求和优先事项至关重要。然而，他们认为重要的概念在评估和护理中并未得到充分体现。本研究的目的是阐明OA患者如何理解、体验和管理他们的OA及疼痛。
进行了一项系统的文献综述，纳入了定性研究（访谈、焦点小组、开放式问卷），不考虑OA的关节部位。收集了与OA及OA相关疼痛的逐字引述，并合并为代码。定义了与这些代码相关的主题和类别。
七个数据库共产生了9585项研究，其中79项定性研究被选中。对2009名参与者的667条逐字引述进行分析，得出了117个代码和24个主题。主题分为“特征”和“管理”两类。“特征”包括从常见挑战（如适应功能减退）到需要治疗关注的高影响结果（如剧痛）等各种体验。“管理”类别涵盖了与药物和认知行为自我管理、心理教育及干预相关的积极和消极观念。两类主题都被分为四个领域：症状、功能、心理和社会。还使用了第五个领域“疾病”来对“特征”下的主题进行分类。
OA患者报告的几个主题在当前的评估和建议中几乎没有体现，例如疲劳、睡眠障碍、心理社会影响以及对家庭和照顾者的影响。所审查的信念、需求和优先事项可能有助于个性化筛查，补充现有的评估工具，并有助于完善干预措施和心理教育材料。
