Knowledge of knee osteoarthritis and its impact on health in the Middle East: are they different to countries in the developed world? a qualitative study in Jordan
Rationale, aims and objectives: limited knowledge of knee OA and its management options decreases adherence to treatment and adversely affect symptoms and functioning. The knowledge and experience of people living in countries from the developed world have been previously explored. However, many socio-cultural differences exist when comparing Jordan, as representative of the Middle East, to developed countries which might influence the impact of knee OA on health. Therefore, this study aimed to explore the knowledge of the pathology and the experience of people diagnosed with knee OA living in Jordan.
Method: fourteen participants were included in the study (13 females, one male). One focus group and seven in depth semi-structured interviews were conducted. The discussions were audio-taped and transcribed. Framework analysis was used and data were mapped to the International Classification of Functioning, Disability and Health framework.
Results: four themes containing eleven sub-themes emerged: Theme 1) Body functions and structures included two sub-themes; physical changes, psychological impact; 2) Activity limitation and participation restriction included three sub-themes; factors influencing the activities, cultural and social perspective to activity limitation and participation restriction; 3) Personal factors included three sub-themes; knowledge and personal interpretation of disease process, knowledge of management options to relief symptoms, influence of personal factors on activity and participation; 4) Environmental factors included three sub-themes; service delivery process, ineffective communication across the care pathway, facilitators and barriers.
Conclusion(s): knowledge of the disease was lacking as a consequence of inappropriate service delivery and the culture. Activity limitations and participation restrictions are similar in Jordan to other cultures in addition to limitations in religious, employment and transportation activities which are the consequences of the geography, the infrastructure, and culture. These results demonstrate the global impact of knee OA on health and the need to understand different cultures to devise optimal management plan.