Functional limitations and coping mechanisms of women aged 60 years and older with self-reported hand osteoarthritis

Abstract

Background: Hand osteoarthritis (HOA) is common in older women who seem to cope with the associated limitations in hand function. The importance of identifying coping mechanisms within a local context might have implications for intervention, especially with the introduction of National Health Insurance. Method: A three-phase sequential exploratory mixed methods design was used. The sample consisted of 71 women aged 60 years and over with self-reported osteoarthritis living in Wentworth, Durban. A screening questionnaire, the Arthritis Impact Measurement Scales 2-Short Form (AIMS2-SF), as well as semi-structured interviews, were used to explore participants’ functional limitations and coping mechanisms. Results: The majority of participants were aged 74 years or younger. Seventy-two per cent accessed health care at the primary healthcare clinic at a seniors’ service centre. Eighty-seven per cent reported hand symptoms, 10% had self-reported, doctor-diagnosed HOA, although 47% met or partially met the American College of Rheumatology criteria for HOA. The AIMS2-SF identified only one common problem caused with respect to functional limitation and coping mechanisms associated with HOA, i.e. managing vigorous activities. Coping mechanisms by the participants included adapting their lifestyle and activities, having a positive attitude and accepting assistance, including spiritual help. Conclusion: There is a gap in the screening and diagnosis of HOA, and a lack of appreciation of its bio-psycho-social effect on women’s general well-being. Holistic healthcare management was not accessible to the participants, nor directed towards improving their quality of life. Participants accessed support that compensated for therapeutic care through spiritual and other means.