The functional and psychological impact of hand osteoarthritis

Abstract

Objectives: Studies suggest that hand osteoarthritis (OA) can result in impairment of hand function and participation restriction. The objective of the current study was to investigate the impact of functional impairments caused by hand OA on everyday life.

Methods: Semi-structured interviews with primary care (n = 15; mean age 62.4 years; M : F ratio 1 : 4) and secondary care (n = 14; mean age 63.6 years; M : F ratio 1 : 13) patients aged 50 years and over were conducted. Data were analysed using thematic analysis and the constant comparison method.

Results: Individuals reported impact across day-to-day activities. Perceptions of dependence and independence were important. They reported embarrassment due to the appearance of their hands and their inability to carry out ‘normal’ tasks. Work status had been affected for two of the participants. Negative emotional responses were captured. Participants utilized cognitive, behavioural and avoidance forms of coping.

Conclusion: We have captured the impact of functional impairment on everyday life and related psychological effects. With a retirement age increasing, the study raises the potential issue of future employment restriction for those with hand OA. Individuals utilising ‘temporal’ comparison as a form of coping may be less well adjusted to their hand problem, which could have implications for future management.

Keywords

Function Hand osteoarthritis Semi-structured interviews

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References

Arthritis Care. OA Nation, 2004. Available at: www.arthritiscare.org.uk (accessed June 2009)

Woolf AD , Zeidler H. , Haglund U. , et al. Musculoskeletal pain in Europe: its impact and a comparison of population and medical perceptions of treatment in eight European countries. Ann Rheum Dis 2004; 63: 342-7.

Sowers M. , Lachance L. , Hochberg M. , Jamadar D. Radiographically defined osteoarthritis of the hand and knee in young and middle-aged African and American and Caucasian women. Osteoarthr Cartil 2000; 8: 69-77.

Felson DT The course of osteoarthritis and factors that affect it. Rheum Dis Clin North Am 1993; 19: 607-15.

Zhang Y. , Niu J. , Kelley-Hayes M. , Chaison CE , Aliabadi P. , Felson DT Prevalence of symptomatic hand osteoarthritis and its impact on functional status among the elderly - The Framingham Study. Am J Epi 2002; 156: 1021-7.

Creamer P. , Hochberg MC Osteoarthritis. The Lancet 1997; 350: 503-9.

Hirsch R. , Guralnik JM , Ling SM , Fried LP , Hochberg MC The patterns and prevalence of hand osteoarthritis in a population of disabled older women: The Women’s Health and Aging Study. Osteoarthr Cartil 2000; 8: S16-S21.

Kjeken H. , Dagfinrud H. , Slatkowsky-Christensen B. , et al. Activity limitations and participation restrictions in women with hand osteoarthritis: patient’s descriptions and associations between dimensions of functioning. Ann Rheum Dis 2005 ; 64: 1633-8.

Thomas E. , Wilkie R. , Peat G. , Hill S. , Dziedzic K. , Croft P. The North Staffordshire Osteoarthritis Project NorStOP: Prospective, 3-year study of the epidemiology and management of clinical osteoarthritis in a general population of older adults. BMC Musculoskelet Disord 2004; 5: 2.

10.

Hill S. , Dziedzic K. , Thomas E. , Baker S. , Croft P. The illness perceptions associated with health and behavioural outcomes in people with musculoskeletal hand problems: findings from the North Staffordshire Osteoarthriris Project (NorStOP). Rheumatol 2007; 46: 944-51.

11.

Hassey A. , Gerrett D. , Wilson A. Information in practice: a survey of validity and utility of electronic patient records in a general practice. BMJ 2001; 322: 1401-05.

12.

Carr AJ A patient-centred approach to evaluation and treatment in rheumatoid arthritis: the development of a critical tool to measure patient-perceived handicap. Br J Rheumatol 1996; 35: 921-32.

13.

Glaser BG , Strauss AL The discovery of grounded theory: strategies for qualitative research . New York: Aldine Publishing Company, 1980.

14.

Hewitt-Taylor J. Use of constant comparative analysis in qualitative research. Nurs Stand 2001; 15: 39-42.

15.

Spence A. , Hasson F. , Waldron M. Active carers: living with chronic obstructive pulmonary disease. Int J Palliat Nurs 2008; 14: 368-72.

16.

Thorne S. Data analysis in qualitative research. Evid Based Nurs 2000; 3: 68-70.

17.

Bouchard C. Lecons sur les auto-intoxications dans les maladies. Paris : Librairie F Savy , 1887: 178-81.

18.

Heberden W. Commentaries on the history and cure of diseases, Vol. 2. London: T Payne, 1802: 148-9.

19.

Festinger L. Theory of social comparison processes. Hum Relat 1954; 7: 117-40.

20.

Albert S. Temporal comparison theory. Psychol Rev 1977 ; 84: 485-503.

21.

Sanders C. , Donovan J. , Dieppe P. The significance and consequences of having painful and disabled joints in older age: co-existing accounts of normal and disrupted biographies. Sociol Health Illn 2002; 24: 227-53.

22.

World Health Organization. International classification of functioning, disability and health: ICF. Geneva: WHO, 2001.

23.

Lempp H. , Scott D. , Kingsley G. The personal impact of rheumatoid arthritis on patients’ identity: a qualitative study. Chronic Illn 2006; 2: 109-20.

24.

Sofaer B. , Moore AP , Holloway I. , Lamberty JM , Thorp TAS , Dwyer JO Chronic pain as perceived by older people: a qualitative study. Age Ageing 2005; 34: 462-6.

25.

Geuskens GA , Burdorf A. , Hazes JMW. Consequences of rheumatoid arthritis for performance of social roles: A literature review . J Rheumatol 2007; 34: 1248-60.

26.

Murphy H. , Dickens C. , Creed F. , Bernstein R. Depression, illness perception and coping in rheumatoid arthritis . J Psychosom Res 1999; 46: 155-64.

27.

Affleck G. , Pfeiffer C. , Tennen H. , Fifield J. Attributional processes in rheumatoid arthritis patients. Arthritis Rheum 1987; 30: 927-31.

28.

Lenze EJ , Rogers JC , Martire LM , et al. The association of late-life depression and anxiety with physical disability. Am J Geriatr Psychiatry 2001; 9: 113-35.

29.

Woolhead GM Patients’ experience of osteoarthritis and total knee replacement . Dissertation submitted to the University of Bristol , Faculty of Medicine 2002, February.

30.

Billings AG , Moos RH The role of coping responses and social resources in attenuating the stress of life events. J Behav Med 1981; 4: 157-89.

31.

Festinger L. Theory of social comparison processes. Hum Relat 1954; 7: 117-40.

32.

Wills TA Downward comparison principles in social psychology. Psychol Bull 1981; 90: 245-71.

33.

Albert S. Temporal comparison theory. Psychol Rev 1977 ; 84: 485-503.

34.

Robinson-Wheelan S. , Kiecolt-Glaser J. The importance of social versus temporal comparison appraisals among older adults. J Appl Social Psychol 1997; 27: 959-66.

35.

Affleck G. , Tennen H. , Pfeiffer C. , Fifield J. Arthritis: accuracy and adaptational significance. J Soc Clin Psychol 1988; 6: 219-34.

36.

DeVillis R. , Holt K. , Renner B. , et al. The relationship of social comparison to rheumatoid arthritis symptoms and affect. Basic Appl Soc Psych 1990; 11: 1-18.