Capturing lay perspectives in a randomized control trial of a health promotion intervention for people with osteoarthritis of the knee. A pilot study of health education via a nurse-run telephone self-management programme for elderly people with osteoarthritis Beliefs about the causes of osteoarthritis among primary care patients. Personal models of osteoarthritis and their relation to self-management activities and quality of life Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial Cognitive representations of illness and functional and affective adjustment following surgery for osteoarthritis. Telephone-Based Self-management of Osteoarthritis Cohort profile: research on Osteoarthritis/Osteoporosis Against Disability study. Testing a Positive Psychological Intervention for Osteoarthritis Self-management approaches for osteoarthritis in the hand: a 2×2 factorial randomised trial Activity Increase Despite Arthritis (AÏDA): phase II randomised controlled trial of an active management booklet for hip and knee osteoarthritis in primary care. Activity Increase Despite Arthritis (AÏDA): design of a Phase II randomised controlled trial evaluating an active management booklet for hip and knee osteoarthritis [ISRCTN24554946] The effectiveness of a self-management program on quality of life for knee osteoarthritis (OA) patients. Impact of the fit and strong intervention on older adults with osteoarthritis. Self-management for osteoarthritis of the knee: Does mode of delivery influence outcome? Family practice nurses supporting self-management in older patients with mild osteoarthritis: a randomized trial The effectiveness of self‐management educational interventions for osteoarthritis of the knee
Osteoarthritis ( OA ) is a common and often disabling condition that predominately affects older adults . It is the commonest cause of locomotor disability and forms a major element of the workload in primary care . Previous studies suggest that there are both deficits in the knowledge patients have about their disease and extensive ' unmet ' information needs . This paper explores the patients ' perspective on the meaning and significance of living with arthritis , identified through quantitative and qualitative approaches undertaken during a trial that evaluated the effectiveness of a primary care-based patient education programme . This paper draws on qualitative and quantitative data from : the baseline interview ( knowledge of arthritis , satisfaction with services and support received in primary care ) ; patient diaries ( individual goals and reflections on treatment ) ; and group teaching sessions ( themes describing the patient 's experience ) . The different data sources were interrogated for common and divergent themes . One hundred and ninety-four participants were identified and 170 completed baseline interviews . Participants were predominantly female ( 73 % ) , with a mean age of 63 and arthritis of long-st and ing ; 55 % reported that they had had it for 5 years or more .  Use of primary care services was high , with 41 % consulting their GP in the 2 weeks before interview . Levels of information were low , with less than 25 % receiving support/advice about the disease , pain management or its impact upon daily life . Set against negative perceptions of the quality of services , patients ' personal priorities were for improved pain management and enhanced mobility/functional ability . The combined quantitative and qualitative data provide insight into the patients ' perspective on the causes and impact of knee OA , individual goals desired from treatment and the quality of care . There is consistent evidence of unmet needs for information and support and the priority placed by patients on finding strategies to cope with OA and maintaining independence . Even within a tightly defined study sample participating in the intervention , a diversity of experience and goals were revealed , which highlights the importance of taking account of context ual factors and individual differences when evaluating complex interventions We conducted a pilot study of a nurse-run telephone self-management programme for elderly people with osteoarthritis ( OA ) . Thirty-two subjects , aged 60 years or more , with a diagnosis of OA were recruited from two hospital rheumatology clinics and were r and omized to a control or intervention group . The intervention group received six weekly mailings of OA health education modules , a relaxation audio-tape and six weekly 45 min follow-up telephone self-management sessions . There was a 100 % compliance rate in the intervention group , and all subjects completed baseline and three-month interviews ; one subject in each group was lost to six-month follow-up . There were no significant differences in self-management between the control and intervention groups . However , at three months there were improvements in the intervention group ( relative to baseline ) on some outcome measures . The results suggest that the telephone may be a useful tool for reinforcing health-promoting activities for patients OBJECTIVE Beliefs about the causes of osteoarthritis ( OA ) have been examined infrequently . The purpose of this study was to provide insight into patients ' beliefs about the causes of OA in a primary care population . METHODS This study involved 31 individuals with OA who were purposively sample d to reflect age , sex , and self-efficacy scores from the intervention arm of a r and omized controlled trial examining the effectiveness of an arthritis self-management program in primary care . Participants took part in face-to-face interviews . Data were analyzed using interpretative phenomenologic analysis . RESULTS A total of 31 patients with OA ( 17 [ 55 % ] men ) with a median age of 68 years ( range 56 - 84 years ) were recruited .  OA and painful joints were considered to be an inevitable aspect of aging rather than an indication of disease . Participants attributed the cause of OA to multiple factors , the most commonly reported being wear and tear . CONCLUSION Insight into beliefs about the causes of OA among older people may help explain attitudes towards the uptake of health care among this group of patients We examined the personal models of osteoarthritis ( OA ) of 61 patients over 60 years of age .  Models were elicited using a structured interview . Shared beliefs included perceiving OA as a serious , painful , chronic , and incurable condition that can be managed by recommended medical treatment . Considerable individual differences were found on six personal-model constructs : Symptoms , Seriousness , Cause , Control , Helpfulness of Treatment , and Negative Feelings about Treatment . The constructs of Symptoms and Seriousness were consistently related to a variety of important outcomes . For example , participants with higher scores on Symptoms and Seriousness reported higher levels of self-management ( both concurrently and prospect ively ) , reported more utilization of medical services , and experienced a poorer quality of life . The implication s for the design of health-education material s and for patient-provider interactions are discussed Background Osteoarthritis ( OA ) is a degenerative disease , considered to be one of the major public health problems . Research suggests that patient education is feasible and valuable for achieving improvements in quality of life , in function , well-being and improved coping . Since 1994 , Primary Health Care in Malmö has used a patient education programme directed towards OA . The aim of this study was to evaluate the effects of this education programme for patients with OA in primary health care in terms of self-efficacy , function and self-perceived health . Method The study was a single-blind , r and omized controlled trial ( RCT ) in which the  EuroQol-5D and Arthritis self-efficacy scale were used to measure self-perceived health and self-efficacy and function was measured with Grip Ability Test for the upper extremity and five different functional tests for the lower extremity . Results We found differences between the intervention group and the control group , comparing the results at baseline and after 6 months in EuroQol-5D ( p < 0.001 ) and in st and ing one leg eyes closed ( p = 0.02 ) in favour of the intervention group . No other differences between the groups were found . Conclusion This study has shown that patient education for patients with osteoarthritis is feasible in a primary health care setting and can improve self-perceived health as well as function in some degree , but not self-efficacy . Further research to investigate the effect of exercise performance on function , as well as self-efficacy is warranted . Trial registration The trial is registered with Clinical Trials.gov . Registration number : A prospect i ve investigation is described which sought to test the role of illness cognitions in determining patient responses to a  surgical intervention for osteoarthritis .  Illness cognitions were assessed amongst a consecutive sample of patients with osteoarthritis of the knee or hip prior to undergoing joint replacement surgery .  Functional activity and depression were assessed pre-operatively , and at 3 and 9 months post surgery . At pre-operative assessment , functional activity and depression were univariately associated with the perceived consequences of osteoarthritis . Path analyses using longitudinal data demonstrated that illness cognitions had predictive value in explaining outcomes . Depression at 3 months was associated with higher pre-operative perceived control beliefs suggesting that patients who have high control pre-operatively may be at risk for temporary depressed mood in the immediate aftermath of surgery . This effect was not maintained at 9 months . Depression at 9 months was lower amongst patients who were more active at 3 months , who did not attribute their condition to wear and tear and who had higher expectations of surgery . Functional activity at 9 months was higher amongst those who did not attribute their condition to growing older and who perceived more control over symptoms . Socio-demographic variables were not associated with change in functional activity or depression over the course of surgery . The results provide support for an illness cognition approach in explaining functional activity and depression outcomes following surgery BACKGROUND Osteoarthritis is a leading cause of pain and disability , and self-management behaviors for osteoarthritis are underutilized . OBJECTIVE To examine the effectiveness of a telephone-based self-management intervention for hip or knee osteoarthritis in a primary care setting . DESIGN R and omized clinical trial with equal assignment to osteoarthritis self-management , health education ( attention control ) , and usual care control groups . ( Clinical Trials.gov registration number : NCT00288912 ) SETTING Primary care clinics in a Veterans Affairs Medical Center . PATIENTS 515 patients with symptomatic hip or knee osteoarthritis . INTERVENTION The osteoarthritis self-management intervention involved educational material s and 12 monthly telephone calls to support individualized goals and action plans . The health education intervention involved nonosteoarthritis educational material s and 12 monthly telephone calls related to general health screening topics . MEASUREMENTS The primary outcome was score on the Arthritis Impact Measurement Scales-2 pain subscale ( range , 0 to 10 ) . Pain was also assessed with a 10-cm visual analog scale . Measurements were collected at baseline and 12 months . RESULTS 461 participants ( 90 % ) completed the 12-month assessment . The mean Arthritis Impact Measurement Scales-2 pain score in the osteoarthritis self-management group was 0.4 point lower ( 95 % CI , -0.8 to 0.1 point ; P = 0.105 ) than in the usual care group and 0.6 point lower ( CI , -1.0 to -0.2 point ; P = 0.007 ) than in the health education group at 12 months . The mean visual analog scale pain score in the osteoarthritis self-management group was 1.1 points lower ( CI , -1.6 to -0.6 point ; P < 0.001 ) than in the usual care group and 1.0 point lower ( CI , -1.5 to -0.5 point ; P < 0.001 ) than in the health education group . Health care use did not differ across the groups . LIMITATION The study was conducted at 1 Veterans Affairs Medical Center , and the sample consisted primarily of men . CONCLUSION A telephone-based osteoarthritis self-management program produced moderate improvements in pain , particularly compared with a health education control group . PRIMARY FUNDING SOURCE U.S. Department of Veterans Affairs Health Services Research and Development Service Since the proportion of the ageing population in Japan is increasing , a comprehensive and evidence based strategy is urgently required for the prevention of musculoskeletal diseases , including osteoarthritis ( OA ) and osteoporosis ( OP ) , both of which affect the activities of daily living ( ADL ) and quality of life ( QOL ) and increase morbidity and mortality . However , few prospect i ve , longitudinal studies for the purpose of developing such a strategy have been conducted , and little information is available regarding the prevalence and incidence of musculoskeletal disorders , including OA and OP , as well as pain and disability in the Japanese population . It is difficult to design rational clinical and public health approaches for the diagnosis , evaluation and prevention of OA and OP without such epidemiological data . The Research on Osteoarthritis/osteoporosis Against Disability ( ROAD ) study was established in 2005 by N.Y. , T.A. , H.O. , S.M. , H.K. and K.N. ( principal investigators ) . The principal investigators are affiliated with the 22nd Century Medical and Research Center , University of Tokyo Objective Osteoarthritis is a leading cause of disability for which there is no cure . Psychosocial-oriented treatments are underexplored . We developed and tested an intervention to build positive psychological skills ( e.g. , gratitude ) to reduce osteoarthritis symptom severity , including pain and functioning , and to improve psychosocial well-being in patients with knee or hip osteoarthritis . Design Two-arm r and omized design with six-month follow-up . Setting An academic Veterans Affairs Medical Center . Subjects Patients aged 50 years or older with knee or hip osteoarthritis and pain ratings of 4 or higher . Methods Patients ( N = 42 ) were r and omized to a six-week program containing positive skill-building activities or neutral control activities tailored to the patient population . Adherence  was assessed by telephone each week . We assessed osteoarthritis symptom severity ( WOMAC Osteoarthritis Index ) and measures of well-being ( positive affect , negative affect , and life satisfaction ) at baseline and by telephone one , three , and six months after the program ended . We used linear mixed models to examine changes over time . Results The majority ( 64 % ) of patients completed more than 80 % of their weekly activities . Patients in the positive ( vs neutral ) program reported significantly more improvement over time in osteoarthritis symptom severity ( P = 0.02 , Cohen 's d = 0.86 ) , negative affect ( P = 0.03 , Cohen 's d = 0.50 ) , and life satisfaction ( P = 0.02 , Cohen 's d = 0.36 ) . Conclusions The study successfully engaged patients with knee or hip osteoarthritis in a six-week intervention to build positive psychological skills . Improving osteoarthritis symptom severity and measures of psychosocial well-being , the intervention shows promise as a tool for chronic pain management Background Osteoarthritis is the leading cause of disability in older adults . Evidence of effectiveness for self-management of h and osteoarthritis is lacking . Methods In this r and omised , factorial trial , we evaluated the effectiveness of joint protection versus no joint protection , and h and exercise versus no h and exercise in adults , 50 years of age or older , with h and osteoarthritis . Following a population survey ( n=12 297 ) , eligible individuals were r and omly assigned ( 1:1:1:1 ) to : leaflet and advice ; joint protection ; h and exercise ; joint protection plus h and exercise . Joint protection and h and exercises were delivered by nine occupational therapists , over four group sessions . The primary outcome was the OARSI/OMERACT responder criteria at 6 months . Outcomes were collected blind to allocation ( 3 , 6 , 12 m ) . Analysis was by intention to treat . Results Of 257 participants r and omised ( 65:62:65:65 ) ( mean age ( SD ) 66 years ( 9.1 ) ; female 66 % ) follow-up was 85 % at 6 m ( n=212 ) . Baseline characteristics and loss to follow-up were similar between groups . There were no reported treatment side effects . At 6 m 33 % assigned joint protection were responders compared with 21 % with no joint protection ( p=0.03 ) . Of those assigned h and exercises , 28 % were responders compared with 25 % with no exercises ( n.s . ) . Differences in secondary outcomes were not statistically significant , except for improvement in pain self-efficacy with joint protection ( 3 m p=0.002 ; 6 m p=0.001 ; 12 m p=0.03 ) . Conclusions These findings show that occupational therapists can support self-management in older adults with h and osteoarthritis , and that joint protection provides an effective intervention for medium term outcome . ( Funded by the Arthritis Research UK IS RCT N 33870549 ) BACKGROUND The Hip & Knee Book : Helping you cope with osteoarthritis was developed to change disadvantageous beliefs and encourage physical activity in people with hip or knee osteoarthritis . AIM To assess the feasibility of conducting a definitive r and omised controlled trial ( RCT ) of this evidence -based booklet in people with hip or knee osteoarthritis . DESIGN Phase II feasibility r and omised controlled trial ( RCT ) . METHOD Computerised search es of patients ' record data bases identified people with osteoarthritis of the hip or knee , who were invited to participate in the RCT comparing the new booklet with a control booklet . Outcomes were measured at baseline , 1 month , and 3 months , and included : beliefs about hip and knee pain , exercise , and fear avoidance ; level of physical activity ; and health service use . RESULTS The trial methods were feasible in terms of recruitment , r and omisation , and follow-up , but most participants recruited had longst and ing established symptoms . After one and 3 months , there was a small relative improvement in illness , exercise , and fear-avoidance beliefs and physical activity level in The Hip & Knee Book group ( n = 59 ) compared with the control group ( n = 60 ) , which provides some proof of principle for using these outcomes in future trials . CONCLUSION This feasibility study provided proof of principle for testing The Hip & Knee Book in a larger definitive RCT Background Hip and knee osteoarthritis is a common cause of pain and disability , which can be improved by exercise interventions . However , regular exercise is uncommon in this group because the low physical activity level in the general population is probably reduced even further by pain related fear of movement . The best method of encouraging increased activity in this patient group is not known . A booklet has been developed for patients with hip or knee osteoarthritis . It focuses on changing disadvantageous beliefs and encouraging increased physical activity . Methods / Design This paper describes the design of a Phase II r and omised controlled trial ( RCT ) to test the effectiveness of this new booklet for patients with hip and knee osteoarthritis in influencing illness and treatment beliefs , and to assess the feasibility of conducting a larger definitive RCT in terms of health status and exercise behaviour . A computerised search of four general medical practice patients ' record data bases will identify patients older than 50 years of age who have consulted with hip or knee pain in the previous twelve months . A r and om sample of 120 will be invited to participate in the RCT comparing the new booklet  with a control booklet , and we expect 100 to return final question naires . This trial will assess the feasibility of recruitment and r and omisation , the suitability of the control intervention and outcome measurement tools , and will provide an estimate of effect size . Outcomes will include beliefs about hip and knee pain , beliefs about exercise , fear avoidance , level of physical activity , health status and health service costs . They will be measured at baseline , one month and three months . Discussion We discuss the merits of testing effectiveness in a phase II trial , in terms of intermediate outcome measures , whilst testing the processes for a larger definitive trial . We also discuss the advantages and disadvantages of testing the psychometric properties of the primary outcome measures concurrently with the trial . Trial registration Current Controlled Trials IS RCT PURPOSE To evaluate the effectiveness of the Taipei Osteoarthritis Program ( TOAP ) for community elderly persons who suffer from knee OA . METHODS A quasi-experimental study was conducted between January 2008 and December 2008 . Two hundred and five community-dwelling individuals aged 67±10 years with knee OA were recruited from four districts in Taipei City and r and omized . By a clustered r and omization according to the districts , 114 participants were in the intervention group ( IG ) with a 4-week TOAP program and 91 participants were in the control group ( CG ) with routine care . The main outcome measures included health-related quality of life ( HRQOL ) and disability level , which were assessed by the Short Form-36 Taiwan Version ( T-SF36 ) and the Western Ontario McMaster Universities Arthritis Index Taiwan Version ( T-WOMAC ) , respectively , and were repeatedly measured at the baseline , post invention ( 4 weeks after baseline ) , and follow-up ( 8 weeks after baseline ) . RESULTS Subjects in the IG increased their changes of GH scores from baseline to post-intervention and follow-up , which were significantly more than those of subjects in the CG ( p=0.011 and 0.005 , respectively ) . Significant difference of changes was also found at follow-up for the mental component scale between the groups ( p=0.013 ) . There was no change in disability level . CONCLUSIONS The arthritis self-management program improved the psychological outcomes among the participants , but it had no significant effect on a self-reported disability level PURPOSE This study assessed the impact of a low cost , multicomponent physical activity intervention for older adults with lower extremity osteoarthritis . DESIGN AND METHODS A r and omized controlled trial compared the effects of a facility-based multiple-component training program followed by home-based adherence  ( n = 80 ) to a  wait list control group ( n = 70 ) . Assessment s were conducted at baseline and at 2 and 6 months following r and omization . The training program consisted of range of motion , resistance training , aerobic walking , and education-group problem solving regarding self-efficacy for exercise and exercise adherence . All training group participants developed individualized plans for posttraining adherence . RESULTS Relative to the persons in the control group , individuals who participated in the exercise program experienced a statistically significant improvement in exercise efficacy , a 48.5 % increase in exercise adherence , and a 13.3 % increase in 6-min distance walk that were accompanied by significant decreases in lower extremity stiffness at 2 and 6 months . Program participants also experienced a significant decrease in lower extremity pain and a borderline significant improvement in efficacy to adhere to exercise over time at 6 months ( p = .052 ) . In contrast , persons in the control group deteriorated over time on the efficacy and adherence measures and showed no change on the other measures . No adverse health effects were encountered . IMPLICATION S These benefits indicate that this low-cost intervention may hold great promise as one of a growing number of public health intervention strategies for older adults in the United States with osteoarthritis Abstract Background Self-management has become increasingly popular in the management of chronic diseases . There are many different self-management models . Meta analyses of arthritis self-management have concluded that it is difficult to recommend any one program in preference to another due to inconsistencies in the study design s used to evaluate different programs . The Stanford Arthritis Self-Management Program ( ASMP ) , most commonly delivered by trained lay leaders , is a generic program widely used for people with rheumatological disorders . We have developed a more specific program expressly for people with osteoarthritis of the knee ( OAKP ) . It includes information design ed to be delivered by health professionals and results in improvements in pain , function and quality of life . Aim : To determine whether , for people with osteoarthritis ( OA ) of the knee , the OAKP implemented in a primary health care setting can achieve and maintain clinical ly meaningful improvements in more participants than ASMP delivered in the same environment . Methods / Design The effectiveness of the programs will be compared in a single-blind r and omized study . Participants : 146 participants with established OA knee will be recruited . Volunteers with coexistent inflammatory joint disease or serious co-morbidities will be excluded . Interventions : Participants will be r and omised into either  OAKP or ASMP groups and followed for 6 months . Measurements : Assessment s will be immediately before and after the intervention and at 6 months . Primary outcome measures will be WOMAC and SF-36 question naires and a VAS for pain . Secondary outcomes will include balance , tested using a timed single leg balance test and a timed step test and self-efficacy . Data will be analysed using repeated measures ANOVA . Discussion With an aging population the health care costs for people with arthritis are ever increasing . Although cost analysis is beyond the scope of this study , it is reasonable to expect that costs will be greater when health professionals deliver self-management programs as opposed to lay leaders . Consequently it is critical to examine the relative effectiveness of the primary care management strategies available for OA.Trial Registration This study is registered with the Australian New Zeal and Clinical Trials Registry : Background Supporting self-management intends to improve life-style , which is beneficial for patients with mild osteoarthritis ( OA ) . We evaluated a nurse-based intervention on  older OA patients ' self-management with the aim to assess its effects on mobility and functioning . Methods R and omized controlled trial of patients ( ≥ 65 years ) with mild hip or knee OA from nine family practice s in the Netherl and s. Intervention consisted of supporting patients ' self-management of OA symptoms using a practice -based nurse . Outcome measures were patients ' mobility , using the Timed Up and Go test ( TUG ) , and patient reported functioning , using an arthritis specific scale ( Dutch AIMS 2 SF ) . Results Fifty-one patients were r and omized to the intervention group and 53 to the control group . Patient-reported functioning improved on four scales in the intervention group compared to one scale in the control group . However , this result was not significant . Mobility improved in both groups , without a significant difference between the two groups . There were no differences between the groups regarding consultations with family physicians or physiotherapists , or medication use . Conclusion A nurse-based intervention on older OA patients ' self-management did not improve self-reported functioning , mobility or patients ' use of health care re sources Background Osteoarthritis ( OA ) is a common cause of pain and disability , and is the most common form of arthritis in the Western world . The most common joint to be affected is the knee . Pain and functional disability are common symptoms , which can lead to reduced quality of life and increase the risk of further morbidity . Current treatment aims to educate patients about the management of OA , reduce pain , improve function , decrease disability and reduce the progression of the disease . Education with clients has been described as a set of planned educational activities design ed to improve patients ' health behaviours and /or health status . The purpose of self‐education is to maintain or improve health , or , in some cases , to slow deterioration by increasing participant 's perception of self efficacy defined as an ability to control or manage various aspects of OA . To date , there is no systematic review of the literature undertaken to identify the effectiveness of self‐management educational activities for osteoarthritis of the knee . Objective The objective of this systematic review is to evaluate the effectiveness of  self‐management educational interventions on function and quality of life for adult subjects with OA of the knee . Search strategy A comprehensive search strategy was undertaken on data bases available from University of South Australia from their inception to January 2007 . Selection criteria R and omised controlled trials or clinical controlled trials were sought which evaluated any self management interventions for osteoarthritis knee . Critical appraisal of study quality was undertaken using Joanna Briggs Institute critical appraisal instruments . Data extraction was via the Joanna Briggs Institute st and ard data extraction form for evidence of effectiveness , and Review Manager Software was used to calculate comparative statistics . Results Thirteen trials were included in the review . Trials were clinical ly and method ologically heterogeneous . Pooled results indicate evidence of a beneficial effect from  self management strategies with reducing pain ( SMD ‐0.25 , 95%CI ‐0.36 to ‐0.13 , 11 trials 1379 participants ) . There was no effect on physical function ( SMD 0.13 , 95%CI ‐0.33 to ‐0.08 , eight trials , 1156 subjects ) . No beneficial effects were found from self management interventions with improving quality of life . We also found the exercise component of self management ( four trials ) demonstrated a benefit with reducing pain , improving function and quality of life . Exercise also offered a benefit over no exercise  . Overall method ological quality was moderate . Discussion Pooled results indicate evidence of a beneficial effect from self management strategies with reducing pain and improving function . Significant heterogeneity was found between trials . This was controlled for in the analysis but may be explained by heterogeneity in both the intervention and control group . The exercise component of self management programmes appears to contribute a significant benefit . Conclusion There is encouraging evidence of a small benefit from exercise in self management programs . Clear guidelines can not be provided for practice regarding the exercise content due to heterogeneity but overall benefit suggests this component should be emphasized and implemented in primary care self management programmes
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 .