Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework
Objectives: Symptomatic knee osteoarthritis (OA) frequently co-occurs in individuals with type 2 diabetes mellitus (T2DM). In the context of T2DM, OA is often underdiagnosed and undertreated. To elucidate strategies to improve OA care in persons with T2DM, we assessed their perceptions of the barrie...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-12-01
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| Series: | Osteoarthritis and Cartilage Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2665913122000735 |
| _version_ | 1797991923788546048 |
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| author | Lauren K. King Owen Krystia Esther J. Waugh Crystal MacKay Ian Stanaitis Jane Stretton Alanna Weisman Noah M. Ivers Janet A. Parsons Lorraine Lipscombe Gillian A. Hawker |
| author_facet | Lauren K. King Owen Krystia Esther J. Waugh Crystal MacKay Ian Stanaitis Jane Stretton Alanna Weisman Noah M. Ivers Janet A. Parsons Lorraine Lipscombe Gillian A. Hawker |
| author_sort | Lauren K. King |
| collection | DOAJ |
| description | Objectives: Symptomatic knee osteoarthritis (OA) frequently co-occurs in individuals with type 2 diabetes mellitus (T2DM). In the context of T2DM, OA is often underdiagnosed and undertreated. To elucidate strategies to improve OA care in persons with T2DM, we assessed their perceptions of the barriers and enablers to seeking and engaging in OA care. Design: We conducted semi-structured interviews with 18 individuals with T2DM and symptomatic knee OA in Ontario, Canada. Transcripts were deductively coded using the Theoretical Domains Framework (TDF), an implementation science framework that incorporates theoretical domains of behaviour determinants, which can be linked to behaviour change techniques. Within each of the relevant domains, data were thematically analyzed to generate belief statements. Results: Seven of the TDF domains prominently influenced the behaviour to seek and engage in OA care. Participants described insufficient receipt of OA knowledge to fully engage in care (knowledge), feeling incapable of participating in physical activity due to joint pain (beliefs about capabilities), uncertainty about effectiveness of therapies (optimism) and lack of guidance from health care providers and insufficient access to community programs/supports (environmental context and resources). Key enablers were strong social support (social influences), sources of accountability (behavioural regulation) and experiencing benefit from treatment (reinforcement). Participants did not see concomitant T2DM as limiting the desire to seek OA care. Conclusions: Among individuals with symptomatic knee OA and T2DM, we identified behavioural determinants of seeking and engaging in OA care. These will be mapped to behavioural change techniques to inform development of a complex intervention. |
| first_indexed | 2024-04-11T08:58:54Z |
| format | Article |
| id | doaj.art-e50ed957973d49f3821e54245c1e5371 |
| institution | Directory Open Access Journal |
| issn | 2665-9131 |
| language | English |
| last_indexed | 2024-04-11T08:58:54Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Osteoarthritis and Cartilage Open |
| spelling | doaj.art-e50ed957973d49f3821e54245c1e53712022-12-22T04:32:57ZengElsevierOsteoarthritis and Cartilage Open2665-91312022-12-0144100305Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains frameworkLauren K. King0Owen Krystia1Esther J. Waugh2Crystal MacKay3Ian Stanaitis4Jane Stretton5Alanna Weisman6Noah M. Ivers7Janet A. Parsons8Lorraine Lipscombe9Gillian A. Hawker10Department of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Corresponding author. Dr. Lauren King. Department of Medicine, University of Toronto, Women's College Research Institute, 6307 - 76 Grenville Street, 6th Floor, Toronto, ON, M5S 1B2, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Physical Therapy, University of Toronto, Toronto, ON, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, ON, CanadaWomen's College Research Institute, Women's College Hospital, Toronto, ON, CanadaPatient Research Partner, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, CanadaWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada; Department of Community and Family Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Physical Therapy, University of Toronto, Toronto, ON, Canada; Applied Health Research Centre and Li Ka Shing Knowledge Institute, St. Michael's Hospital – Unity Health Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Women's College Hospital, Toronto, ON, CanadaObjectives: Symptomatic knee osteoarthritis (OA) frequently co-occurs in individuals with type 2 diabetes mellitus (T2DM). In the context of T2DM, OA is often underdiagnosed and undertreated. To elucidate strategies to improve OA care in persons with T2DM, we assessed their perceptions of the barriers and enablers to seeking and engaging in OA care. Design: We conducted semi-structured interviews with 18 individuals with T2DM and symptomatic knee OA in Ontario, Canada. Transcripts were deductively coded using the Theoretical Domains Framework (TDF), an implementation science framework that incorporates theoretical domains of behaviour determinants, which can be linked to behaviour change techniques. Within each of the relevant domains, data were thematically analyzed to generate belief statements. Results: Seven of the TDF domains prominently influenced the behaviour to seek and engage in OA care. Participants described insufficient receipt of OA knowledge to fully engage in care (knowledge), feeling incapable of participating in physical activity due to joint pain (beliefs about capabilities), uncertainty about effectiveness of therapies (optimism) and lack of guidance from health care providers and insufficient access to community programs/supports (environmental context and resources). Key enablers were strong social support (social influences), sources of accountability (behavioural regulation) and experiencing benefit from treatment (reinforcement). Participants did not see concomitant T2DM as limiting the desire to seek OA care. Conclusions: Among individuals with symptomatic knee OA and T2DM, we identified behavioural determinants of seeking and engaging in OA care. These will be mapped to behavioural change techniques to inform development of a complex intervention.http://www.sciencedirect.com/science/article/pii/S2665913122000735OsteoarthritisType 2 diabetes mellitusQualitativeTheoretical domains framework |
| spellingShingle | Lauren K. King Owen Krystia Esther J. Waugh Crystal MacKay Ian Stanaitis Jane Stretton Alanna Weisman Noah M. Ivers Janet A. Parsons Lorraine Lipscombe Gillian A. Hawker Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework Osteoarthritis and Cartilage Open Osteoarthritis Type 2 diabetes mellitus Qualitative Theoretical domains framework |
| title | Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework |
| title_full | Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework |
| title_fullStr | Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework |
| title_full_unstemmed | Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework |
| title_short | Understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus: A qualitative study using the theoretical domains framework |
| title_sort | understanding the behavioural determinants of seeking and engaging in care for knee osteoarthritis in persons with type 2 diabetes mellitus a qualitative study using the theoretical domains framework |
| topic | Osteoarthritis Type 2 diabetes mellitus Qualitative Theoretical domains framework |
| url | http://www.sciencedirect.com/science/article/pii/S2665913122000735 |
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