Background & Aims

Osteoarthritis (OA) is the most common form of arthritis, the most prevalent musculoskeletal disorder [1], as well as one of the leading causes of pain and chronic disability worldwide [2-4], with a consequent reduction in quality of life, constant pain experience, and limitations in the performance of daily tasks [5, 6]. It is postulated that OA patients’ health-seeking behaviour depends mainly on the disease severity and loss of function [7], and some engage in pluralistic health-seeking behaviour that involves vacillation among conventional, complementary, and alternative medicine [8-10]. Although the literature is substantial on the prevalence, pain, and functional limitations of older persons with OA, the patterns and undercurrents of their health-seeking behaviours are less explored. Thus, the study’s objectives were to assess pain characteristics, activity limitation, and their influence on the health-seeking behaviour of older adults with OA.

Methods

This is a cross-sectional study conducted in Ile-Ife, Nigeria. The sample comprised 230 purposively selected older adults 60 years and older living with OA. The inclusion criterion was being symptomatic for OA for at least three months. Data were collected one-on-one by one of the authors using an interviewer-administered questionnaire. Pain characteristics, activity limitation and health-seeking behaviour of the respondents were assessed using the Chronic Pain Grade Scale [11], the Western Ontario and McMaster Universities Arthritis Index[12], and Health-Care Seeking Behaviour Questionnaire[13, 14], respectively. Factors impeding their HSB, such as choice of clinic and cost, were also explored. Data were analysed using descriptive statistics of frequency, percentages, and graphs. A test of association between variables was conducted with chi-square. Multiple regression was conducted to assess factors that predict health-seeking behaviour, and the alpha level was set at p <0.05.

Results

Respondents’ age ranged from 60 to 99 years (76.37±11.23). They described their pain as mostly occurring at the knee (73%), occurring frequently (51.3%), severe (59.1%), pain deep within the bone (47.0%), and associated with joint swelling and stiffness (30.4%). Overall, the majority (59.1%) of the respondents experienced severe pain, 45.2% had severe limitations, and 55% had negative health-seeking behaviour. Results further showed that pain severity (p=0.001), exacerbation (p=0.009), description (p < 0.001), and presence of joint swelling and stiffness (p=0.038) were significantly associated with functional limitation. In addition, religion (p=0.008) and pain severity (p=0.001) were significantly associated with functional limitations, and age, sex, marital status, and ethnicity were significantly associated with health-seeking behaviour (p<0.05). Predictors of health-seeking behaviour among the respondents included cost, preference, ethnicity, employment, and marital status.

Conclusions

The findings of this study established that individuals with OA experience considerable pain, which has a negative influence on their overall physical health and also limits their ability to function in daily life. They are more likely to engage in negative health-seeking behaviour to find relief from pain. Therefore, evidence-based management of OA should be incorporated into community health services at all levels of health care. Community-dwelling adults living with OA must be identified and provided with interventions such as exercise, weight reduction, pharmacological interventions, and assistive devices for a healthy life.

References

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3.Ziebland, S., et al., Informing the development of NICE (National Institute for Health and Care Excellence) quality standards through secondary analysis of qualitative narrative interviews on patients’ experiences. 2015.
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8.Andarini, S., et al., Factors associated with health care seeking behavior for musculoskeletal pain in Indonesia: A cross?sectional study. International journal of rheumatic diseases, 2019. 22(7): p. 1297-1304.
9.Ramsey, S.D., et al., Use of alternative therapies by older adults with osteoarthritis. Arthritis Care & Research: Official Journal of the American College of Rheumatology, 2001. 45(3): p. 222-227.
10.Herman, C.J., et al., Peer reviewed: use of complementary therapies among primary care clinic patients with arthritis. Preventing Chronic Disease, 2004. 1(4).
11.Manraj, K. and M. Saurabh, Chronic pain grade questionnaire. J Physiother, 2013. 59: p. 60.
12.Ackerman, I., Western ontario and mcMaster universities osteoarthritis index (WOMAC). Aust J Physiother, 2009. 55(3): p. 213.
13.Reid, A.D., Acculturation, perceived social support, and health-related quality of life as factors in health-care-seeking behavior among African-American women. 2000: University of Florida.
14.Adewole, A.O., O. Ajumobi, and S. Gidado, Health care seeking behaviour for visual dysfunction among motor vehicle drivers in Osun State, Southwest Nigeria. Pan African medical journal, 2019. 32(1).

Presenting Author

Joel Faronbi

Poster Authors

Joel Faronbi

PhD

University of Exeter

Lead Author

Dorcas Ayobami Akinlose

Lead Author

Bolaji Agboola

Lead Author

Chidozie Mbada

Machester Metropolitian University, Manchester, UK

Lead Author

Topics

  • Pain in Special Populations: Elderly