title: A grounded patient-centered approach generated the personal and societal burden of osteoarthritis model.
abstract: OBJECTIVE
  To develop a conceptual model to describe the burden of osteoarthritis in individuals with this condition and on the broader community.
  
  
  METHODS
  Six concept mapping workshops were undertaken: three with patients (n = 26) and three with health professionals (n = 27) in Australia and Sweden. The participants were asked to generate statements describing how osteoarthritis affects individuals with this condition and those around them. The results were used to construct an integrated theoretical model of the personal burden of osteoarthritis (PBO) and its extended version, the personal and societal burden of osteoarthritis (PSBO) model.
  
  
  RESULTS
  We identified eight potentially independent aspects of PBO, including physical distress, fatigue, physical limitations, psychosocial distress, physical deconditioning, financial hardship, sleep disturbances, and lost productivity. Physical distress and impaired physical function combined to produce psychosocial problems, reduced work productivity, financial difficulties, and loss of physical fitness at the individual level, and increased health and welfare cost at the societal level.
  
  
  CONCLUSIONS
  The PBO and PSBO models were developed directly from the views of patients and clinicians and provide new insights for managing the individual and societal burden of osteoarthritis.
authors.affiliation: Melbourne EpiCentre, Department of Medicine, University of Melbourne and Melbourne Health, 7 East, Royal Melbourne Hospital, Parkville, Melbourne VIC 3050, Australia. l.busija@deakin.edu.au
authors.forename: Lucy
authors.initials: L
authors.lastname: Busija
authors.forename: Rachelle
authors.initials: R
authors.lastname: Buchbinder
authors.forename: Richard H
authors.initials: RH
authors.lastname: Osborne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017281:Cost of Illness; D004526:Efficiency; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010003:Osteoarthritis / Q000150:complications / Q000191:economics / Q000523:psychology; D018802:Patient-Centered Care; D012946:Social Welfare / Q000191:economics; D013312:Stress, Physiological; D013315:Stress, Psychological / Q000209:etiology; D013548:Sweden
keywords: Burden of illness; Mixed methods research; Osteoarthritis; Patient-centered outcomes; Quality of life; Theoretical model