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Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence

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Abstract

With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding. A full scoping review was conducted across five databases resulting in 656 abstracts screened. All text was coded using the categorization matrix and resulting subthemes were identified. A total of 74 articles were analyzed with 23 subthemes identified across the nine categories. Four new perspectives emerged to support OA care for Asian populations: (1) the importance of family and peer assistance, (2) the importance of culturally specific activities, (3) distrust in western medicine, and (4) impact of positive coping mechanisms on health appraisals. While Asians are more susceptible to knee and hand OA because of their cultural lifestyle factors (e.g. squatting for chores, hygiene and religious activities), and traditional beliefs on OA management (e.g. traditional diet, topical oils, physical therapy), many do not present themselves for conventional treatments (e.g. surgery) until all traditional treatments are exhausted. The results suggest that cultural factors influence the uptake of OA management practices among Asians. Greater awareness of these cultural factors may improve diagnosis, treatment, and management of OA among Asian patients.

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Acknowledgements

The authors acknowledge the Collaborative Training Program in Musculoskeletal Health Research and the Faculty of Health Sciences at Western University for financially supporting this research via an undergraduate summer studentship grant. The authors also thank Ms. Roxanne Isard, a research librarian, for triangulating and confirming the results yielded by the research databases.

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  1. Sam Katz Community Health and Aging Research Unit, Faculty of Health Sciences, Western University, Arthur & Sonia Labatt Health Sciences Building, Room 316, 1151 Richmond Street, London, ON, N6A 5B9, Canada

    Thrmiga Sathiyamoorthy, Shabana Amanda Ali & Marita Kloseck

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Sathiyamoorthy, T., Ali, S.A. & Kloseck, M. Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence. J Community Health 43, 816–826 (2018). https://doi.org/10.1007/s10900-018-0470-8

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