Patient Disease Perceptions and Coping Strategies for Arthritis in a Developing Nation: A Qualitative Study

BMC Musculoskeletal Disorders

Research Article

Luis Alcantara Abreu¹  Roya Ghazinouri²  Laura M Bogart³  Aileen M Davis⁴  Nina N Niu⁵  Thomas S Thornhill⁵  Jeffrey N Katz⁶ 

[1] Department of Orthopedic Surgery, Hospital General de la Plaza de la Salud, Avenida Ortega y Gasset, Dominican Republic;Department of Physical Therapy, Brigham and Women's Hospital, Tower 2C 75 Francis Street, 02115, Boston, USA;Division of General Pediatrics, Children's Hospital Boston, 300 Longwood Avenue, 02115, Boston, USA;Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, 02115, Boston, USA;Division of Healthcare and Outcomes Research, Toronto Western Research Institute, 399 Bathurst St, Toronto, Canada;Arthritis Community Research & Evaluation Unit, Toronto Western Research Institute, 399 Bathurst St., Toronto, Canada;Graduate Departments of Health Policy, Management and Evaluation and Rehabilitation Science, University of Toronto, 500 University Avenue, Toronto, Canada;Department of Physical Therapy, University of Toronto, 500 University Avenue, Toronto, Canada;Orthopedic and Arthritis Center for Outcomes Research, Brigham and Woman's Hospital, 75 Francis Street BC-4-4016, 02115, Boston, USA;Orthopedic and Arthritis Center for Outcomes Research, Brigham and Woman's Hospital, 75 Francis Street BC-4-4016, 02115, Boston, USA;Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, 75 Francis Street, 02115, Boston, USA;

关键词: Arthritis;    Coping Strategy;    Religious Coping;    Dominican Republic;    Social Support Network;   

DOI  :  10.1186/1471-2474-12-228

 received in 2011-03-21, accepted in 2011-10-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThere is little prior research on the burden of arthritis in the developing world. We sought to document how patients with advanced arthritis living in the Dominican Republic are affected by and cope with their disease.MethodsWe conducted semi-structured, one-to-one interviews with economically disadvantaged Dominican patients with advanced knee and/or hip arthritis in the Dominican Republic. The interviews, conducted in Spanish, followed a moderator's guide that included topics such as the patients' understanding of disease etiology, their support networks, and their coping mechanisms. The interviews were audiotaped, transcribed verbatim in Spanish, and systematically analyzed using content analysis. We assessed agreement in coding between two investigators.Results18 patients were interviewed (mean age 60 years, median age 62 years, 72% women, 100% response rate). Patients invoked religious and environmental theories of disease etiology, stating that their illness had been caused by God's will or through contact with water. While all patients experienced pain and functional limitation, the social effects of arthritis were gender-specific: women noted interference with homemaking and churchgoing activities, while men experienced disruption with occupational roles. The coping strategies used by patients appeared to reflect their beliefs about disease causation and included prayer and avoidance of water.ConclusionsPatients' explanatory models of arthritis influenced the psychosocial effects of the disease and coping mechanisms used. Given the increasing reach of global health programs, understanding these culturally influenced perceptions of disease will be crucial in successfully treating chronic diseases in the developing world.

【 授权许可】

CC BY   
© Niu et al; licensee BioMed Central Ltd. 2011