Jennifer Winter Di Cola1, Shahiroz Juma2, Deborah Kennedy3, Patricia Dickson4, Suzanne Denis3, Susan Robarts5, Jeffrey Gollish6, Fiona Webster7. 1. Hospital for Sick Children, Toronto. 2. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre ; Department of Physical Therapy. 3. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre ; Department of Physical Therapy ; School of Rehabilitation Science, McMaster University, Hamilton, Ont. 4. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre ; Department of Occupational Science and Occupational Therapy. 5. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre. 6. Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre ; Department of Surgery. 7. Department of Family and Community Medicine ; Institute of Health Policy Management and Evaluation, University of Toronto, Toronto.
Abstract
PURPOSE: To understand whether a visit to a Hip/Knee Arthritis Assessment Centre (AC), where non-surgical candidates with arthritis are directed toward community resources and provided with a conservative treatment "prescription," contributes to patients' self-management and ability to access community resources. METHODS: A purposive sample of non-surgical patients was contacted 3-10 months after their AC visit. Three focus groups (n=20) and 20 semi-structured telephone interviews were conducted. Transcripts were systematically coded and analyzed using a qualitative descriptive research methodology. RESULTS: While participants generally reported that the AC visit improved self-management, analysis identified an emergent theme about the inadequacy of conservative management in general, subdivided into two sub-themes related to (1) limited access to high-quality, non-surgical treatment, such as physiotherapy and (2) health care providers' attitudes and approaches, which do not embrace chronic disease prevention and management. CONCLUSIONS: An AC visit contributes to arthritis self-management; however, the current health care system does not adequately support conservative treatment of chronic conditions. Treatment guidelines need to be tailored to the local health care context in which they are applied.
PURPOSE: To understand whether a visit to a Hip/Knee Arthritis Assessment Centre (AC), where non-surgical candidates with arthritis are directed toward community resources and provided with a conservative treatment "prescription," contributes to patients' self-management and ability to access community resources. METHODS: A purposive sample of non-surgical patients was contacted 3-10 months after their AC visit. Three focus groups (n=20) and 20 semi-structured telephone interviews were conducted. Transcripts were systematically coded and analyzed using a qualitative descriptive research methodology. RESULTS: While participants generally reported that the AC visit improved self-management, analysis identified an emergent theme about the inadequacy of conservative management in general, subdivided into two sub-themes related to (1) limited access to high-quality, non-surgical treatment, such as physiotherapy and (2) health care providers' attitudes and approaches, which do not embrace chronic disease prevention and management. CONCLUSIONS: An AC visit contributes to arthritis self-management; however, the current health care system does not adequately support conservative treatment of chronic conditions. Treatment guidelines need to be tailored to the local health care context in which they are applied.
Entities:
Keywords:
disease management; health services accessibility; osteoarthritis; survey
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