Misconceptions and the Acceptance of Evidence-based Nonsurgical Interventions for Knee Osteoarthritis. A Qualitative Study A patient's beliefs and expectations profoundly influence the effectiveness of our interventions and the overall outcome of a plan of care. Belief effects modulate interventions and the amount of information retained. If a patient does not believe PT intervention will work, the impact will be blunted. Unfortunately, many of the common beliefs about osteoarthritis create an uphill battle for rehabilitation. Patients often feel nonsurgical interventions are of little value in the treatment of knee OA. This paper explored those misconceptions through interviews with 27 patients on a TKA waiting list. The main theme within identity beliefs was 'bone on bone.' The main theme within causal beliefs was OA resulted from excessive loading through the knee. The main theme within consequence beliefs was a fear of falling and damaging the joint. The main theme within timeline beliefs was OA has a downward trajectory, it is urgent, and it signifies the end of the road. When you combine those beliefs, it's easy to see why the participants believed PT can't help and a mechanical fix is required. As clinicians, it is our job to update a patient's knowledge. Behavior and belief change takes time and bombarding them with contradictory information often falls short. Motivational interviewing can be a helpful strategy to facilitate a conversation and help a patient reconceptualize OA and how activity can help them.
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