Management of Osteoarthritis – should nurses be more involved?
I have long advocated self management of osteoarthritis. As a society we are becoming reliant on others providing solutions to all our problems and preferably ‘magic pills’ with regard to our health-care.
We need to take responsibility for the things we can change and also stop beating ourselves up about things that are not our fault.
This was published in The American Journal of Medicine by Laura Robbins (senior vice president for education and academic affairs at the Hospital for Special Surgery, New York City) and Marjorie G. Kulesa (past president of the National Association of Orthopaedic Nurses) about a symposium that was held recently.
They call for nurses to be better utilised in the management of osteoarthritis saying:
“Nurses are in a unique position to inform and support their patients’ self-management, and there are many strategies that can help them better encourage it. Multimodal, multilingual, and racially and culturally appropriate patient education materials can be developed at multiple literacy levels, as can online programs, especially for use in rural areas.”
The authors discuss many ways that nurses can help directly help people with the management of osteoarthritis including
– Assessment for risk and progression of osteoarthritis.
– Interventions that relieve symptoms and minimize disease progression.
– Self management.
Self Management of Osteoarthritis
I consider self management for osteoarthritis vital in the controlling of osteoarthritis symptoms. I agree with the author’s analysis that patients need education and then supporting as they change their behaviour.
“Self-management support is an important aspect of OA treatment. In this era of health care reform, more attention is being focused on the self-management of OA, and it is one of the four goals of the U.S. Department of Health and Human Services’ strategic framework for dealing with chronic conditions.23 The ACR’s OA guideline identifies self-management education, physical activity, and weight loss as key management strategies.14 There is consensus on what specific self-management activities patients should undertake, but less agreement on how health care professionals and others can support these activities. Nurses in particular have a role to play in education as well as support, including referral, progress assessment, goal setting, and problem solving.24
Behavior-changing and skill-building interventions work toward exercise performance and weight loss. Physical activity interventions can be delivered in a number of ways—in the home or in health care, community, or workplace settings. No single format has been found to be superior, but programs of longer duration (12 or more supervised sessions) give better results.15 A recent meta-analysis of exercise delivered in a community setting found clinically significant improvements in pain and function.25 There are few weight loss programs targeted specifically at OA.”
I think a greater role by nurses in the management of osteoarthritis is an excellent idea. They have the trust of patients and are, in general good communicators with more time to listen as we moan on about our osteoarthritis! However the medical profession would need to support them making sure they undergo further training to ensure they give the correct advice and are up to date on the latest osteoarthritis treatment guidelines.
What do you think? Do you think practice nurses should be more involved with the care and management of osteoarthritis? Leave a comment and like us on Facebook so we can build a community to help and support one another!