Giving an account of patients' experience: A qualitative study on the care process of hip and knee osteoarthritis

Simone Battista, Mattia Manoni, Andrea Dell'Isola, Martin Englund, Alvisa Palese, Marco Testa

Research output: Contribution to journalArticlepeer-review


Introduction: Despite the publication of clinical practice guidelines, the quality of the care process as experienced by patients with osteoarthritis (OA) appears suboptimal. Hence, this study investigates how patients with OA experience their disease and care process, highlighting potential elements that can enhance or spoil it, to optimise their quality of care. Methods: A qualitative study based on semi-structured interviews. Patients with hip and knee OA in Italy were interviewed. The interview guide was created by a pool of health professionals and patients. The interviews were analysed through a theme-based analysis following a philosophy of descriptive phenomenological research. Results: Our analysis revealed seven main themes: (1) Experiencing a sense of uncertainty, as interviewees perceived treatment choices not to be based on medical evidence; (2) Establishing challenging relationships with the self and the other, as they did not feel understood and felt ashamed or hopeless about their condition; (3) Being stuck in one's own or the health professionals' beliefs about the disease management, as a common thought was the perception of movement as something dangerous together with a frequent prescription of passive therapies; (4) Dealing with one's own attitudes towards the disease; Understanding (5) the barriers to and (6) the facilitators of the adherence to therapeutic exercise, which revolve around the therapy cost, the time needed and the patients' willingness to change their life habits and (7) Developing an uneasy relationship with food since the diet was considered as something that “you force yourself to follow” and overeating as a way “to eat your feelings”. Conclusion: The lack of clear explanations and a negative attitude towards first-line nonsurgical treatments (mainly physical exercise), which are considered as a way to fill the time while waiting for surgery, underlines the importance of providing patients with adequate information about OA treatments and to better explain the role of first-line intervention in the care of OA. This will enhance patient-centred and shared decision-making treatments. Patient Contribution: Patients with hip and knee OA participated in creating the interview and contributed with their experience of their care process.

Original languageEnglish
Pages (from-to)1140-1156
JournalHealth Expectations
Issue number3
Early online date2022
Publication statusPublished - 2022

Subject classification (UKÄ)

  • Nursing
  • Rheumatology and Autoimmunity
  • Public Health, Global Health, Social Medicine and Epidemiology

Free keywords

  • clinical governance
  • osteoarthritis
  • phenomenology
  • physical therapists
  • physical therapy specialty
  • policy making
  • practice guidelines as topic


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