The overarching themes indicated people with osteoarthritis delay their diagnosis , opting for self-management and informal information gathering .
This informal rather than health professional-led guidance is sought and maintained as an important re source throughout the care of this population and is valued .
There remains uncertainty regarding when this is required , but the expected failure of conservative treatment to manage pain and symptoms is common .
This may provide a more valuable perception of non-operative management to promote its adoption and adherence in managing osteoarthritis
Abstract This paper determines the perceptions of people diagnosed with osteoarthritis towards their conservative management strategies .
Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee
STUDY OBJECTIVES To underst and reasons for compliance and non-compliance with a home based exercise regimen by patients with osteoarthritis of the knee . DESIGN A qualitative study , nested within a r and omised controlled trial , examining the effectiveness of physiotherapy in reducing pain and increasing mobility in knee osteoarthritis . In the intervention arm , participants undertook a series of simple exercises and repositioning of the kneecap using tape . In depth interviews were conducted with a subset of participants in the intervention arm using open ended questions , guided by a topic schedule , to encourage patients to describe their experiences and reflect on why they did or did not comply with the physiotherapy . Interviews were audiotaped , fully transcribed and analysed thematically according to the method of constant comparison . A model explaining factors influencing compliance was developed . SETTING Patients were interviewed at home . The study was nested within a pragmatic r and omised controlled trial . PARTICIPANTS Twenty participants in the intervention arm of the r and omised trial were interviewed three months after they had completed the physiotherapy programme . Eight were interviewed again one year later . MAIN RESULTS Initial compliance was high because of loyalty to the physiotherapist . Reasoning underpinning continued compliance was more complex , involving willingness and ability to accommo date exercises within everyday life , the perceived severity of symptoms , attitudes towards arthritis and comorbidity and previous experiences of osteoarthritis . A necessary precondition for continued compliance was the perception that the physiotherapy was effective in ameliorating unpleasant symptoms . CONCLUSIONS Non-compliance with physiotherapy , as with drug therapies , is common . From the patient 's perspective , decisions about whether or not to comply are rational but often can not be predicted by therapists or research ers . Ultimately , this study suggests that health professionals need to underst and reasons for non-compliance if they are to provide supportive care and trialists should include qualitative research within trials whenever levels of compliance may have an impact on the effectiveness of the intervention
The overarching themes indicated people with osteoarthritis delay their diagnosis , opting for self-management and informal information gathering .
This informal rather than health professional-led guidance is sought and maintained as an important re source throughout the care of this population and is valued .
There remains uncertainty regarding when this is required , but the expected failure of conservative treatment to manage pain and symptoms is common .
This may provide a more valuable perception of non-operative management to promote its adoption and adherence in managing osteoarthritis
Abstract This paper determines the perceptions of people diagnosed with osteoarthritis towards their conservative management strategies .