Beliefs About the Causes of Osteoarthritis Among Primary Care Patients A. P. TURNER, 1 J. H. BARLOW, 1 M. BUSZEWICZ, 2 A. ATKINSON, 2 AND G. RAIT 2 Objective. Beliefs about the causes of osteoarthritis (OA) have been examined infrequently. The purpose of this study was to provide insight into patients’ beliefs about the causes of OA in a primary care population. Methods. This study involved 31 individuals with OA who were purposively sampled to reflect age, sex, and self-efficacy scores from the intervention arm of a randomized controlled trial examining the effectiveness of an arthritis self- management program in primary care. Participants took part in face-to-face interviews. Data were analyzed using interpretative phenomenologic analysis. Results. A total of 31 patients with OA (17 [55%] men) with a median age of 68 years (range 56 – 84 years) were recruited. OA and painful joints were considered to be an inevitable aspect of aging rather than an indication of disease. Participants attributed the cause of OA to multiple factors, the most commonly reported being wear and tear. Conclusion. Insight into beliefs about the causes of OA among older people may help explain attitudes towards the uptake of health care among this group of patients. KEY WORDS. Chronic disease; Osteoarthritis; Patients’ beliefs; Interviews. INTRODUCTION Arthritis is the single largest cause of disability in the UK, with osteoarthritis (OA) being the most prevalent type. OA is the fourth most frequently predicted cause of health problems in women and the eighth most frequently pre- dicted cause in men in the developed world (1). The United Nations, the World Health Organization, and 37 countries have proclaimed the years 2000 –2010 as the Bone and Joint Decade. This global initiative is intended to improve the lives of individuals with musculoskeletal dis- orders, such as arthritis, and to advance understanding and treatment of musculoskeletal disorders through pre- vention, education, and research. Despite the large numbers of persons affected, OA is often overlooked as a topic of psychosocial research (2). Understandings of health and illness are important in de- termining how patients perceive and cope with their situ- ation. Individuals experiencing chronic illness attempt to make sense of their illness in terms of their past life expe- riences using narrative reconstruction (3). There is little published evidence of beliefs among persons with OA, apart from several studies from the US (4,5) and Australia (6,7) and 1 UK study (2). All of these studies, comprising community, predominantly female samples, found that patients reported several causes of their OA, including aging, wear and tear, and genes/heredity. The purpose of this study was to examine beliefs among primary care patients with OA living in the UK who had recently en- rolled in an arthritis self-management program. PATIENTS AND METHODS Ethics. The trial received multicenter research ethics committee approval from the London office prior to com- mencement of the trial in summer 2000 (reference MREC/ 99/2/87). Local research ethics committee approval was also obtained in all areas where patients were recruited to the trial. Participants. This qualitative study forms part of a ran- domized controlled trial examining the effectiveness of the Challenging Arthritis (CA) course among persons with OA. The main trial involved 800 patients recruited from 70 general practices in the UK. All participants were 50 years of age and had a clinical diagnosis of OA. Partici- Supported by the Medical Research Council (MRC refer- ence G9900306/ISCRTN 74878628). 1 A. P. Turner, PhD, J. H. Barlow, Professor: Interdiscipli- nary Research Centre in Health, Coventry University, Cov- entry, UK; 2 M. Buszewicz, MD, A. Atkinson, BA Hons, G. Rait, MD: Royal Free & University College Medical School, London, UK. Address correspondence to A. P. Turner, PhD, Interdisci- plinary Research Centre in Health, Coventry University, Coventry CV1 5FB, UK. E-mail: a.turner@coventry.ac.uk. Submitted for publication September 8, 2005; accepted in revised form June 20, 2006. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 57, No. 2, March 15, 2007, pp 267–271 DOI 10.1002/art.22537 © 2007, American College of Rheumatology ORIGINAL ARTICLE 267