Research Proposal on "Osteoarthritis Among Middle Age Females"

Research Proposal 8 pages (3868 words) Sources: 15 Style: APA

[EXCERPT] . . . .

Osteoarthritis Among Middle Age Females

Osteoarthritis

Osteoarthritis among middle aged females

The issue of osteoarthritis is one that presents many challenges to the nurse and to the healthcare professionals at all levels. The general demographic of this condition is largely female and tends to occur particularly in women over the age of forty. The literature on this topic also emphasizes the complexity of treating osteoarthritis. This is due to the wide range of external factors that are necessary for a full comprehension of this condition.

This paper will firstly provide a brief overview of the subject with the intention of focusing on factors that impact the treatment of middle-aged female patients. Aspects that will be dealt with include demographics and pervasiveness as well as extraneous factors that affect the patient in terms of quality of life as well as treatment protocols. These will include social as well as political, economic and other factors.

Following from this analysis, the Implications in practice for professionals, the community and nursing will be explored. This will be followed by a discussion on various political action plans or strategies that are or should be implemented with the aim of improving the treatment and understanding of this condition.

CONTENT

History and Description of the Issue

A common definition is this disease is provided by Walker ( 2009). "Osteoarthritis is a degenerative disorder of the synovial joints that results in localised loss of hyaline cartilage, remodeling of underlying bone and osteophyte formation at the joint margins" (p.35). The disease is also characterized by a range of common symptoms, which include "…joint pain, stiffness and limited range of movement" (Walker, 2009, p. 35). While the disease can negatively affect any synovial joint, it usually impacts the hands, hips as well as lumbar or cervical spine and the shoulders and feet (Walker, 2009, p. 35).

A central facet of osteoarthritis in terms of nursing care and the larger social and political implications of the disease that will be discussed in this paper, is that nurses may often encounter patients with osteoarthritis even though this may not be the main reason for seeking health care (Walker, 2009, p. 35) in other words, the condition can be a contributing aspects in other healthcare issues that the patient may exhibit. In this regard it is also important to note that Osteoarthritis is a complex disorder which becoming more prevalent among the middle to older age groups. Furthermore, "Biomechanical factors such as intra-articular fractures and sports injuries, such ascruciate ligament tears in the knee or lateral ligament damage in the foot, may predispose individuals to developing osteoarthritis as a result of joint instability" (Walker, 2009, p. 35)

Importantly, experts also note with a great deal of consistency that, "The incidence of osteoarthritis increases with age and affects women more than men" (Walker, 2009, p. 35). Another factor that should be borne in mind is that, "The co-existence of OA and obesity has been realized by epidemiologists for decades & #8230; Epidemiological data suggest that obesity is of very large importance for the development of knee OA" ( Bliddal et al. 2006, p. 323).

It is therefore obvious from the brief points mentioned above that osteoarthritis is a condition that is complicated in terms of its epidemiology and history of treatment. The complexity of his condition becomes clear when we consider the research studies that indicate the extent of the contributing factors that can cause this disease. For example, genetic inheritance is one of the factors linked to the pervasiveness of this condition." Familial studies have demonstrated that inheritance is a considerable factor, especially in hand and generalized osteoarthritis" ( Schroeder, 2010). However, there are also social issues that are important to take into account in understanding and treating osteoarthritis. These will be discussed in detail in the following sections of this paper.

In terms of signs and symptoms, pain and stiffness usually occur but pain may in fact be absent in some cases. While pain is usually only felt in association with movement, in extreme forms of osteoarthritis pain can even occur when the individual is at rest. One of the implications of this is restriction of movement and the ability to care for oneself - which has obvious nursing implications. Clinical features can include "…crepitus, reduced range of movement, joint instability, joint line tenderness, pain on movement or when the joint is being stressed, and mild synovitis…( Schroeder, 2010).

Pervasiveness and Demographics

According to Schroeder (2010), an alarmingly high number of adults suffer from various forms of arthritis. The figure is as high as twenty-two percent or forty-six million individuals in the United States alone (Schroeder, 2010). This figure increases with age and "…50% of adults 65 years and older report an arthritic diagnosis" (Schroeder, 2010). Research also indicates that arthritic diagnoses are not limited to adults but also affect children.

In the United States and Canada and in other countries there has also been a concomitant increase in reports of patients with osteoarthritis. This is linked to the increase in other contributing factors such as obesity and poor fitness levels. As one pundit states: "10 million individuals already have osteoporosis and 18 million more have low bone mass, placing them at increased risk for this disease. One out of every two women and one in eight men over 50 will have an osteoporosis-related fracture in their lifetime" (Osteoarthritis: The most common form, this disease affects 20.7 million Americans (usually over age 45).

An important fact that is stressed by many healthcare experts is that this disease is not necessarily a natural consequence of ageing. There are other factors that need to be considered, particularly with regard to the middle-age groups. Women are demographically more prone to most forms of osteoarthritis, except for hip osteoarthritis, which has the same degree of prevalence in men. It has been found that this form of arthritis is "… a major health problem in postmenopausal women, and the condition is more debilitating in this population" (Wright et al. 2008. p.1736)

Epidemiology and Research

Epidemiology as the study of factors affecting the state of health or illness of a certain population is important in order to understand the interventions and the necessary management of diseases and health problems in a particular social environment. This leads to the analysis of causal factors in osteoarthritis. In terms of the high incidence of this condition among older women, one of the causal factors that have been isolated is a deficiency of the hormone estrogen, which is linked to bone deterioration and loss of calcium." This often occurs at menopause in women" (Osteoarthritis: The most common form, this disease affects 20.7 million Americans (usually over age 45).

It is important to point out that osteoarthritis can be classified as primary or secondary. Primary osteoarthritis is "…an idiopathic phenomenon, meaning there is no apparent initiating factor. Primary osteoarthritis is related to the aging process and the individual may be asymptomatic" (Schroeder, 2010). However, what is of special concern is secondary osteoarthritis. This form of osteoarthritis is mainly caused by additional factors, such as obesity, repeated trauma, congenital abnormalities, diabetes, gout or surgery to the joint structure (Schroeder, 2010).

This has wide ranging implications not only for policy and politics, but also for nursing praxis. As one study remarks, " a good knowledge of this condition, its effects on functional ability and the consequences of living with it will assist healthcare professionals to support patients and aid their recovery from medical or surgical co-morbidities (Walker, 2009, p. 35).

This in turn leads to various management strategies that need to take these extra or external factors into account.

5. Social and Other Determinants

In the light of the above discussion, the social determinants, such as political, environmental and health issues and forces need to be taken into account in ascertaining their effect on the female patient. This refers as well to factors pertinent to nursing, such as the context of pain and pain reduction and to the important issue of quality of life, including the limiting effects of this condition on life and experience. All of these aspects need to be taken into account, in conjunction with other social and environmental factors, in determining nursing strategies and management

For example, a middle- aged or older woman may live alone and will be constricted by her condition in various ways - which necessitates a particular set of nursing protocols. "Treatment needs to be tailored to suit different circumstances and outcomes need to be monitored. Healthcare professionals should review the effect of symptomatic osteoarthritis on individuals' function, quality of life, occupation and leisure activities periodically" (Walker, 2009. P.35).

Therefore, social, environmental, political as well as economic determinants need or be understood in relation not these patients. Notwithstanding the feminist view that women in general are prejudiced against and marginalized in most modern societies, including Canada, there are other factors that need to be taken into consideration when dealing with this demographic. For instance, a link has… READ MORE

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