Expressing pain and fatigue: a new method of analysis to explore differences in osteoarthritis experience

Objective To apply a new method of analysis to 2 large qualitative datasets in order to examine differences in osteoarthritis (OA) experience according to the affected joint (knee or hip) and sex. Methods A secondary analysis of qualitative data from 2 studies was conducted. Study 1 comprised 28 focus groups with 50 men and 80 women (ages 47-92 years). Study 2 comprised 14 focus groups with 32 men and 56 women (ages 56-91 years). All participants had symptomatic OA. In Study 1, secondary analysis using comparative keyword analysis (CKA) compared relative frequencies of words uttered by participants experiencing knee pain with words used by participants experiencing hip pain. In Study 2, CKA compared words used by men with words used by women. Subsequent analysis explored the contexts in which participants used key words. Results All participants in Study 1 described concerns with their bodies, activity limitations, and pain management, but details of their concerns differed. People with knee pain focused on stairs, weight, and stiffness, while those with hip pain were concerned with sidedness and groin pain. In Study 2, both men and women discussed activity and interaction with spouses. However, men used more factual words, especially relating to enumeration, while women offered more explanation without prompting from others. Conclusion CKA provides productive inroads into qualitative datasets. Understanding the different ways that affected joints are discussed, and sex differences in descriptions of OA, may lead to improvements in clinical assessment tools, better targeting of interventions, and enhanced communication between health care professionals and patients.