title: "Just get on with it": qualitative insights of coming to terms with a deteriorating body for older women with osteoarthritis.
abstract: OBJECTIVE
  To qualify the psychosocial burden of osteoarthritis for older women and identify factors perceived to assist with psychological adjustment to the disease.
  
  
  METHODS
  Women who indicated being diagnosed/treated for osteoarthritis in the previous three years in the fifth survey of the Australian Longitudinal Study on Women's Health provided the sampling frame. Participants were randomly sampled until saturation was reached using a systematic process. Thematic content analysis was applied to the 19 semi-structured telephone interviews using a realist framework.
  
  
  RESULTS
  The findings indicate that the emotional burden of osteoarthritis is considerable, and the process of psychological adjustment complex. Older women with osteoarthritis have psychological difficulties associated with increasing pain and functional impairment. Psychological adjustment over time was attributed primarily to cognitive and attitudinal factors (e.g. stoicism, making downward comparisons and possessing specific notions about the cause of arthritis). This was a dynamic 'day to day' process involving a constant struggle between grieving physical losses and increasing dependence amidst symptom management.
  
  
  CONCLUSIONS
  The findings of this study add to the current understanding of the complex processes involved in psychological adjustment over time. Targeted interventions focused on assisting women with arthritis redefine self-concepts outside the confines of caring responsibilities, coupled with public health education programs around understanding the destructive nature of arthritis are required. Understanding the destructive and (potentially) preventable nature of arthritis may facilitate early detection and increased uptake of appropriate treatment options for osteoarthritis that have the ability to modify disease trajectories.
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Harris
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Byles
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia; Faculty of Health, University of Technology Sydney, Broadway, NSW, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.affiliation: Priority Research Centre for Gender, Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Loxton
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D006801:Humans; D008875:Middle Aged; D010003:Osteoarthritis / Q000523:psychology*