MEDICAL INSIDER
DR CORA LIM-FOR EDITING
FOR JUNE 18, 2023
Correlation between Family APGAR scores
and health-related quality of life of Filipino
elderly patients with knee osteoarthritis
(Part 1)
This presentation will describe the clinical profile of
Filipino patients with knee osteoarthritis (OA) and
correlate their health-related quality of life (HrQoL)
with perceived family support.
This presentation is taken from a cross-sectional,
analytical study of patients seen at the Philippine
General Hospital Arthritis Clinic diagnosed with
knee OA using the American College of
Rheumatology classification criteria.
Ninety patients with 3:1 female-to-male ratio, mean
age of 70.14 years qualified for the study. Fifty-
three considered their family to be highly
functional, 28 moderately dysfunctional and nine
severely dysfunctional.
The study described the clinical profile of 90
elderly patients with knee OA and the relationship
of HrQoL to Family APGAR scores. The study
concludes that higher Family APGAR scores in
this population correlated with better HrQoL.
As an introduction, Osteoarthritis (OA) is the most
common joint disease in adults. It has also been
called degenerative joint disease or joint failure
and is characterized by hyaline articular cartilage
loss, and subchondral bone reactions consisting of
bony eburnations, osteophytes and sclerosis.
The Subcommittee on Osteoarthritis of the
American College of Rheumatology Diagnostic
and Therapeutic Criteria Committee defined
osteoarthritis as ‘a heterogeneous group of
conditions that lead to joint symptoms and signs
which are associated with defective integrity of
articular cartilage, in addition to related changes in
the underlying bone at the joint margins’.
‘Clinically, it is characterized by joint pain,
tenderness, limitation of movement, crepitus,
occasional effusion, and variable degrees of local
inflammation. It is a chronic disease associated
with physical disability and may require life-long
treatment.
According to the Global Burden of Osteoarthritis in
the year 2000 by Symmons et al. it has been
estimated that approximately 10% of the world’s
population who are 60 years or older have
symptomatic problems that can be attributed to
OA. OA of the knee is a major cause of mobility
impairment, particularly among women and OA
was estimated to be the 10th leading cause of
non-fatal burden in the world in 1990.
In the Philippines, prevalence studies noted OA in
2.6-4.1% in individuals 20 years of age and older,
in both urban and rural Philippines.
Let us look at the ELDERLY AN THE FILIPINO
FAMILY. Age is a major risk factor for OA. The
Philippines is home to 5.8 million senior citizens
(aged 60 years and higher). Of the total number of
households in the Philippines (15.3 million),
17.13% (2.6 million households) are headed by
senior citizens.
Caring for the elderly is an integral part of Filipino
family dynamics where welfare of each member is
of utmost importance, otherwise, the Filipino value
of ‘debt of gratitude’ is infected in children caring
for their parents and the elderly members of their
family.
In the Philippine society caring for the elderly is
expected and several generalize staying in one
household is common. The family is considered as
the major source of economic, moral,
psychological and emotional support.
Several studies have explored the effect of family
support on chronic pain,” quality of life (Qol.) of
cancer patients.
A study done in Korea by Lim et al., identified the
relationship between perceived pain, family
support and Qol. in patients with ankylosing
spondylitis and concluded that reduction of pain in
ankylosing spondylitis is possible through
adequate family support.
A study published in 1990 by Jamison and Kitti,”
examined the role of family support in chronic pain
patients. The study showed that patients with non-
supportive families had more pain sites and tended
to show greater pain behavior and emotional
distress than those with supportive families.
Perceived family support was important in the
rehabilitation of chronic pain patients. (To be
continued)