The concept of physical limitations in knee osteoarthritis: as viewed by patients and health professionals
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To comprehensively identify components of the physical limitation concept in knee osteoarthritis (OA) and to rate the clinical importance of these using perspectives of both patients and health professionals.
Concept mapping, a structured group process, was used to identify and organize data in focus groups (patients) and via a global web-based survey (professionals). Ideas were elicited through a nominal group technique and then organized using multidimensional scaling, cluster analysis, participant validation, rating of clinical importance, and thematic analyses to generate a conceptual model of physical limitations in knee OA.
Fifteen Danish patients and 200 international professionals contributed to generating the conceptual model. Five clusters emerged: ‘Limitations/physical deficits’; ‘Everyday hurdles’; ‘You’re not the person you used to be’; ‘Need to adjust way of living’; and ‘External limitations,’ each with sub-clusters. Patients generally found their limitations more important than the professionals did.
Patients and professionals agreed largely on the physical limitation concept in knee OA. Some limitations of high importance to patients were lower rated by the professionals, highlighting the importance of including patients when conceptualizing patient outcomes. These data offer new knowledge to guide selection of clinically relevant outcomes and development of outcome measures in knee OA.
KeywordsKnee OA Physical limitations Patient perspective Concept mapping
We would like to thank the patients and health professionals who participated in this study. This study was supported by grants from The Oak Foundation, The Danish Physiotherapy Association, and The Danish Rheumatism Association. Financial support was provided from The Parker Institute and Deakin University.
Conflict of interest
The authors declare that they have no conflict of interests that could influence their work and conclusions in relation to this manuscript.
Informed consent was obtained from all individual patients included in the study.
- 1.Bellamy, N., Kirwan, J., Boers, M., Brooks, P., Strand, V., Tugwell, P., et al. (1997). Recommendations for a core set of outcome measures for future phase III clinical trials in knee, hip, and hand osteoarthritis. Consensus development at OMERACT III. Journal of Rheumatology, 24(4), 799–802.PubMedGoogle Scholar
- 5.Buchbinder, R., Batterham, R., Elsworth, G., Dionne, C. E., Irvin, E., & Osborne, R. H. (2011). A validity-driven approach to the understanding of the personal and societal burden of low back pain: Development of a conceptual and measurement model. Arthritis Res Ther, 13(5), R152.PubMedCentralCrossRefPubMedGoogle Scholar
- 6.Merskey, H., Bonica, J. J., Carmon, A., Dubner, R., Kerr, F. W. L., Lindblom, U., et al. (1979). Pain terms: A list with definitions and notes on usage. Recommended by the IASP subcommittee on Taxonomy. Pain, 6(3), 249.Google Scholar
- 15.Crabtree, B. F., & Miller, W. L. (1999). Using codes and code manuals—a template organizing style of interpretation. In B. F. Crabtree & W. L. Miller (Eds.), Doing qualitative research (2nd ed., pp. 163–177). Thousand Oaks: Sage.Google Scholar
- 17.Bellamy, N., Buchanan, W. W., Goldsmith, C. H., Campbell, J., & Stitt, L. W. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15(12), 1833–1840.PubMedGoogle Scholar
- 20.Osborne, R. H., Elsworth, G. R., & Whitfield, K. (2007). The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Education and Counseling, 66(2), 192–201.CrossRefPubMedGoogle Scholar