RESUMO
Background In a situation of COVID 19 pandemic subjects suffering from osteoarthritis pain will be suffering from mental and physical symptoms due to lockdown and there will be difficulty to assess the healthcare facility. According to the World Mental Health Atlas (2014), the number of psychiatrist per lakh of population in India was 0.75, with even lesser number of psychologists and psychiatric social workers. Even the median number of psychiatrists is only 0.2/100,000 in India as opposed to a global median of 3/100,000 population. Telepsychiatry can bring about a revolution as in capacity building by leveraging digital technology in the present situation. This study helps to find those KOA subjects who are suffering depression and to improve their quality of life by providing them aids of treatment. Aims and Objectives Aim To study the health-related quality of life and depression in subjects with knee osteoarthritis pain. Objectives PRIMARY 1. To study the health-related quality of life in older adult subjects with knee osteoarthritis pain. 2.To study the severity of depression in older adult subjects with knee osteoarthritis pain. SECONDARY 1.To study the relation between health-related quality of life and knee osteoarthritis pain in older adult subjects. 2.To study the relation between knee osteoarthritis pain and depression. 3.To study the relation between health-related quality of life and depression among studied older adult subjects. Methods Subjects aged more than 50 full filling selection criteria are recruited from the Department of Orthopaedic Surgery, KGMU, Lucknow. 1.Mobile numbers of subjects from the records available in the department of Orthopaedics were collected from JANUARY 2018 to JANUARY 2020 2.Subjects those who were on treatment for knee osteoarthritis from the department of Orthopaedic Surgery were contacted over telephone and recruited according to the selection criteria for the study. Call was recorded after taking consent. 3.Subjects were contacted during the daytime 10 am -2pm. If patients subjects and attenders were not comfortable with the time, they were asked for the suitable time to contact them. 4.Subjects were approached for three times. If not answering for three times they were considered as out of reach 5.Survey was completed in maximum 2 sessions,15 minutes each if the subject was not comfortable in answering in a single session. 6.Proper introduction of doctor calling them was given to the subjects and attenders and the purpose of telephone call was informed to the subjects and attenders. 7.After the informed consent which has been recorded on the telephone subjects were interviewed on the basis of sociodemographic questionnaire. 8.Following basic interview subjects were evaluated using scales which includes PHQ-9, SF-12 and WOMAC. 9.HR QOL was measured by SF-12 which includes general health, limitation of activities, physical health, emotional health and social activities. 10.PHQ-9 to assess the diagnosis and severity of depression was applied. 11.WOMAC scale was applied which gives the status of pain, stiffness and physical disabilities. 12.Each assessment took 20-30 minutes. All the answers given over phone were recorded by the principal investigator. 13.If subjects and attenders, ask for advice regarding the treatment were addressed properly following guidance from consultants. 14.For the subjects with depression, advice was given to consult the geriatric mental health helpline number of KGMU. 15.Subjects were divided into 2 main groups depressed and non-depressed and also divided into three groups based on KL grading into KL grade 2, KL grade 3 and KL grade 4 and further analysis was done accordingly. Ethics UNIVERSITY ETHICS COMMITTEE-103rd ECM II B-Thesis/P24, N0;1391/Ethics/2020 Results Results showed that there is significant difference in pain and general health related quality of life based on the KL grading of Knee osteoarthritis.(P=0.02,P=0.04)There is significant difference in pain between males and females and females have more severity of pain,(p=0.001) Am ng the depressed and non-depressed group, depressed group have more pain ,(P=0.026) There is significant difference in pain based on duration of Knee osteoarthritis, (p=0.05).There is significant difference in physical function between depressed and non- depressed group, depressed group having more physical dysfunction. There is significant association between stiffness and health related quality of life, P=0.001. Pain is positively correlated with depression,(P=0.001). Study concluded that pain and general health related quality of life worsens with higher grading of Knee osteoarthritis. Pain is more in females and depressed group. Physical function is lesser in depressed group. As stiffness increases health related quality of life decreases. Pain increases as the duration of Knee osteoarthritis increases and pain is correlated with pain. Discussion Depression in the elderly may emerge because of general medical illnesses, especially those, such as OA, that cause prolonged suffering, leading the patient to physical disability and loss of autonomy. The impact of depression is important, since depressed individuals are more likely to report chronic pain, or pain of greater intensity. This fact can be a complicating factor in the process of treatment adherence and may still increase the perception of pain. The depressive disorder, when associated with physical illness, can cause the emergence of anxiety symptoms. Women have higher rates of depression, anxiety and need family support and it is more common in age above 60. Conclusion The studies previously done ordinarily incorporate pain and function scores however have not regularly included psychosocial factors evaluating QoL, which likewise impacts how patients feel, work, and endurance. Study concluded that there is significant difference in pain and general health related quality of life based on the KL grading of KOA. Pain and general health related quality of life worsens with higher grading of KOA. There is significant difference in pain between males and females and depressed and non-depressed group. Pain is more in females and depressed group. There is significant difference in physical function between depressed and non-depressed group. Physical function is lesser in depressed group. There is significant difference in pain based on duration of Knee osteoarthritis. Pain increases as the duration of KOA increases. As stiffness increases health related quality of life decreases. Pain is positively correlated with depression. 73rd Annual National Conference of Indian Psychiatric Society 2022 January 20 - 23, Vizag Conventions, PM Palem, Visakhapatnam Theme : Bridging Minds... Connecting Generations