title: "We're all looking for solutions": a qualitative study of the management of knee symptoms.
abstract: OBJECTIVE
  While the prevalence of osteoarthritis (OA) increases with age, the first signs begin in the fourth or fifth decade. Little is known about how younger adults respond to OA. This study explores how people ages 35-65 years manage knee symptoms.
  
  
  METHODS
  Six focus groups were conducted with 41 participants (mean age 50.9 years, 63% women) who self-reported a diagnosis of OA or reported knee symptoms (i.e., pain, aching, or stiffness) on most days of the past month. Purposive sampling was used, seeking variation in age and sex. The principles of constructivist grounded theory guided data collection and analysis. Data were analyzed using a constant comparative method.
  
  
  RESULTS
  Participants engaged in a process of proactively trying to find ways to control knee symptoms and disease progression. Their approach to management was not linear, but rather a process that moved back and forth between searching for "solutions" and active management (ongoing use of strategies). During the process, participants consulted health care providers, but often perceived that medical care offered limited options and guidance. Management was constructed as a "never-ending" process that entailed effort and personal resources.
  
  
  CONCLUSIONS
  Participants were proactive in seeking ways to manage knee OA symptoms. There is a mismatch between participants' proactive approach and the reactive approach of the health care system that has focused on late-stage disease. Programs and supports within the formal and informal health care system are required to enable people to successfully manage knee symptoms across their lifespan.
authors.affiliation: Toronto Western Research Institute and University of Toronto, Toronto, Ontario, Canada.
authors.forename: Crystal
authors.initials: C
authors.lastname: MacKay
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Badley
authors.forename: Susan B
authors.initials: SB
authors.lastname: Jaglal
authors.forename: Joanna
authors.initials: J
authors.lastname: Sale
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000628:therapy; D010342:Patient Acceptance of Health Care