الفهرس 
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Abstract
Knee osteoarthritis (KOA), known as degenerative joint disease, is typically the
result of wear and tear and progressive loss of articular cartilage. It is most common in
elderly women and men (Springer, 2019). It increases with obesity and age (Vos et al.,
2016). Other risk factors associated with knee OA such as female sex, hypertension,
raised glucose, history of knee injury, varus/valgus malalignment, physical workload
and occupations involving repetitive knee or hip bending and lifting (Yoo et al., 2018).
Self-management are interventions designed to educate patients in self-care
activities that promote health and management of diseases, increasing their motivation
and decreasing the negative effects on their daily function (Sarris and Wardle, 2019).
Supporting elderly people to self-manage has resulted in reduced use of general
practitioners, and admissions to hospital, significant gains in health status and increased
symptom control (Dineen-Griffin et al., 2019).
A convenience sample of 100 elderly patients (60 years and over) diagnosed
with osteoarthritic knee including both sex, were recruited. They were assigned
randomly by tossing a coin for two groups (study group from University Hospital and
control group from Educational Hospital). Study group who received self-management
intervention beside treatment regimen, while control group received treatment regimen
only.
Elderly patients had a medical history of stroke or other disorder that substantially
affected lower-extremity function were excluded.Tools of data collection
Tool I: An interviewing questionnaire:
This questionnaire was developed by the researcher based on pertinent literature
which includes:
Part 1: Demographic data: age, gender, marital status, and level of education......etc.
Part 2: Present and past history of chronic diseases
Part 3: Questions related to medication administration (are you taking any medication
for chronic disease except for knee osteoarthritis?, are you using analgesics
and anti-inflammatory medication?)
Part 4: Knowledge assessment questionnaire regarding knee osteoarthritis (definition of
knee osteoarthritis?, Causes of knee osteoarthritis? )
Part 5: Practice assessment questionnaire regarding management of associated
symptoms with knee osteoarthritis ( pain, swelling, stiffness, fatigue and
insomnia).
Tool II: Visual Analogue Scale (VAS): It was developed by Bain et al., (2005) to
assess the level of pain intensity.
Tool III: Arthritis self-efficacy scale: (ASES): It was developed by Lorig et al.,
(1989) to assess self-efficacy of patients with osteoarthritis.
Tool IV: Western Ontario and Mcmaster Universities Osteoarthritis (WOMAC)
index: It was developed by Bellamy et al., (1988). It was used as a self-reported questionnaire for evaluating patients with knee OA.
The main results of the study revealed that:
The results of this study showed that 74% of studied elderly patients were aged 60 - 70 years, 26% were aged 71-80 years.
Approximately, more than half of studied elderly patients (56%) were
females.
The majority of the studied elderly patients suffered from chronic diseases other than KOA. Hypertension and diabetes were the highest percentages among
studied elderly patients: hypertension (86.2%), diabetes mellitus (41.4 %).
Approximately 40% of the studied elderly patients had moderate degree of
osteoarthritis and 36% were overweight.
There was increasing in mild pain response among studied elderly patients from 10% in pre-intervention to 40% in post- intervention.
There was increasing in the mean total pain self-efficacy score among study
group from 17.6 ±7.8 in pre-intervention to 28.7 ± 9.4 in post-intervention.
There was increasing in the mean total other symptoms self-efficacy score
among study group from 22.6±9.6 to 41.1± 10.6 after intervention.
There was decreasing in the mean total physical function WOMAC score among
study group from 37.5 ± 12.7 to 33.3 ± 12.4 after intervention.
There was decreasing in the mean total WOMAC scale score among study group
from 43.8 ± 9.8 to 33.4±13.5 after intervention
There was an improvement in study group patient’s knowledge aft
intervention.
There was a relation between self-efficacy (pain and ot symptoms)subscales
and degree of osteoarthritis and level of pain intensity .
There was a relation between physical function/ stiffness subscales and degree
of osteoarthritis and level of pain intensity.
Conclusion:Based on the findings of the current study, it can be concluded that:
Implementation of self-management for elderly patients with knee osteoarthritis was effective in managing pain and related symptoms (joint swelling, fatigue, stiffness
and insomnia) among study group compared to control group. After 3 months of self- management intervention, the total patient’ knowledge score was improved. By utilizing WOMAC index scale, the current findings demonstrated improvement in physical
function among study group, while there was no significance differences between study
and control group regarding stiffness scale.
Recommendations:
Based on the findings of the current study, the following recommendations are
proposed:
1. Awareness management intervention for elderly patients and their family about
self-management related knee osteoarthritis by geriatric nurse in all settings for
enhancing self-efficacy and improving physical function
2. Emphasize the need for the elderly people to practice joint protection measures that
protect knee joint from further damage.
3. Early detection of knee osteoarthritis new cases with accurate diagnosis and prompt management.
4. Integrate weight control program in elderly care as an element of routine primary
health care policies.
5. Developing and implementing apreventive program that limit progression of knee osteoarthritis in young age.