Gignac MA, Davis AM, Hawker G, Wright JG, Mahomed N, Fortin
PR, Badley EM. “What do you expect? You’re just
getting older”: A comparison of perceived osteoarthritis-related
and aging-related health experiences in middle- and older-age
adults. Arthritis Rheum. 2006 Nov 30;55(6):905-912. [Pub
Med ID 17139636]
Objective
To compare the health experiences of middle- and older-age adults with
moderate osteoarthritis symptoms with experiences of individuals
with no chronic health conditions. Similarities and differences in
health changes, the meaning of these changes, and their impact
were examined.
[more…]
Much of the current literature is limited to perceptions of older adults
with severe OA. We also lack information that compares individuals
who define themselves as having OA with those who do not live with a chronic
disabling illness.
Methods
Sixteen focus groups (10 OA, 6 control) were conducted with 53 women and
37 men (age 39-88 years). OA participants were recruited from
practitioners' offices and the Arthritis Society, Ontario Division. Additional
OA participants and controls were recruited from community centers
and newspaper advertisements. All participants were asked about
changes in health, the impact of these changes, and self-management
strategies. Participants also completed standardized measures including
the Short Form 36 Health Survey (SF-36); Western Ontario and McMaster
Universities Osteoarthritis Index (WOMAC) and Disabilities of the Arm, Shoulder,
and Hand questionnaire.
[more…]
The SF-36 assessed health status, and the WOMAC assessed pain, stiffness,
and function. Focus groups transcripts were analyzed using content
analysis, a method for systematically making inferences from text.
Results
Differences in the depth, breadth, and meaning of symptoms such as pain,
stiffness, and fatigue were reported with little overlap between
OA and control groups. OA was often seen as part of a normal aging
process requiring acceptance, not treatment. However, younger OA
participants reported more distress and frustration managing their disease. OA
participants reported an impact of their health on work, leisure,
social activities, and relationships that was described as upsetting compared
with controls.
[more…]
Variability in descriptions of pain were not related to the age of
participants or the location of their OA (i.e., knee or hand). Although
discussions of pain were uncommon in the control groups, the
dimensions used overlapped with those of the OA group. Despite
talking at length about symptoms, OA respondents often minimized
or normalized their condition. One participant noted, “[I have]
nothing much to complain [about] except for this stiffness and shooting
pain.” OA respondents reported that they had relayed their health concerns
to health professionals who either ignored symptoms or suggested
that they were a normal part of aging. Comments included: “My
doctor tells me all the time, ’You're just getting older.’”
Conclusions
This study illuminates personal and social factors associated with OA
by comparing health experiences of individual with OA and controls. It
highlights directions for future research that can improve our
understanding of the needs of individuals with OA and can help link individuals'
health status to the broader framework of their lives.
[more…]
Noteworthy, however, was that pain was the predominant early signal
to individuals with OA that all was not well. Control participants
rarely discussed pain. When they did, its transient nature, aching
quality, and clear link to activities involving physical exertion
differentiated it from pain described by OA participants. OA participants
of all ages reported a vast range of pain descriptors not linked
to the location of their disease. These findings suggest that a
single question or summary score of pain severity may not accurately capture
individuals’ experiences.
List of Tables and Figures (in the publication)
- Table 1. Focus Group Questions.
- Table 2. Health Status Measures.
- Table 3. Signs and Symptoms of Osteoarthritis and Aging.
- Table 4. Dimensions of Measurement.
- No figures for this paper.
Selected Tables from the Publication (with interpretation)
Table 1. Focus group questions.
OA Groups:
- Have there been any changes in your health that you feel are a result of
your OA? Can you describe these changes, if any?
- What, if anything, has been the impact or effect of these OA symptoms on
your life?
- What, if anything, have you done about your OA?
- How do you feel about your OA and its impact? What about the future?
- Has your OA affected your relationships with others or do you anticipate
it will affect your relationship with others?
Control group:
- Have there been any changes in your health that you feel are
a result of aging? Can you describe these changes, if any?
- What, if anything, has been the impact or effect of these age-related health
changes on your life?
- What, if anything, have you done about changes in your health due to aging?
- How do you feel about your health and aging and its impact? What about
the future?
- Has your health as you’ve aged affected your relationships with
others or do you anticipate it will affect your relationship with others?
Table 2. Health status measures. i
| |
Scale |
OA Group |
Control Group |
P |
| SF-36 version 2 |
|
|
|
| |
Physical component |
42.7 ± 8.8 |
54.8 ± 4.8 |
0.00 |
| |
Mental component |
49.8 ± 12.2 |
52.7 ± 8.5 |
0.22 |
| WOMAC |
|
|
|
| |
Physical function |
32.6 ± 13.1 |
19.3 ± 4.7 |
0.00 |
| |
Pain |
10.3 ± 3.9 |
5.8 ± 1.6 |
0.00 |
| |
Joint stiffness |
4.6 ± 2.0 |
2.8 ± 1.2 |
0.00 |
| DASH |
|
|
|
| |
Transformed score |
18.4 ± 16.6 |
4.9 ± 7.6 |
0.00 |
Supplementary Tables (with interpretation)
No supplementary information is available for this paper.
- Values are the mean ± SD unless otherwise indicated. OA
= osteoarthritis; SF-36= Short Form 36 health Survey; WOMAC
= Western Ontario and McMaster Universities Osteoarthritis
Index; DASH= Disabilities of the Arm, Shoulder, and Hand questionnaire.
