Abstract
The overall purpose of this research programme is to develop and test the feasibility of a complex intervention for knee pain delivered by a nurse, and comprising both non-pharmacological and pharmacological interventions. In this first phase, we examined the acceptability of the non-pharmacological component of the intervention; issues faced in delivery, and resolved possible challenges to delivery. Eighteen adults with chronic knee pain were recruited from the community. The intervention comprised holistic assessment, education, exercise, weight-loss advice (where appropriate) and advice on adjunctive treatments such as hot/cold treatments, footwear modification and walking aids. After nurse training, the intervention was delivered in four sessions spread over five weeks. Participants had one to one semi-structured interview at the end of the intervention. The nurse was interviewed after the last visit of the last participant. These were audio recorded and transcribed verbatim. Themes were identified by one author through framework analysis of the transcripts, and cross-checked by another. Most participants found the advice from the nurse easy to follow and were satisfied with the package, though some felt that too much information was provided too soon. The intervention changed their perception of managing knee pain, learning that it can be improved with self-management. However, participants thought that the most challenging part of the intervention was fitting the exercise regime into their daily routine. The nurse found discussion of goal setting to be challenging. The nurse-led package of care is acceptable within a research setting. The results are promising and will be applied in a feasibility randomised-controlled trial.
Highlights
Knee osteoarthritis (OA) affects 16% of the general population worldwide [1] and its’ management remains challenging in most healthcare systems due to the sheer disease burden and limits on resources
Eighteen adults with chronic knee pain were recruited from the community
Most participants found the advice from the nurse easy to follow and were satisfied with the package, though some felt that too much information was provided too soon. The intervention changed their perception of managing knee pain, learning that it can be improved with
Summary
Knee osteoarthritis (OA) affects 16% of the general population worldwide [1] and its’ management remains challenging in most healthcare systems due to the sheer disease burden and limits on resources. Whether nurses can be trained to effectively deliver a complex non-pharmacological intervention for knee OA that includes components that are traditionally delivered by other allied healthcare professionals is yet to be determined This is likely to be possible as previous studies have demonstrated efficacy of nurse-led care over usual GP-led care for chronic conditions when following a protocol, e.g., type II diabetes, heart failure, hypertension and gout [9,10,11,12,13,14,15]. Practitioners only implement an intervention as intended if they find it acceptable to deliver [19]
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