LIVING WITH KNEE OSTEOARTHRITIS AMONG MALAY ADULTS IN MALAYSIA: ATTITUDES, PERCEPTIONS, AND SOCIOCULTURAL INFLUENCES FROM A MIXED-METHODS STUDY

Amrie Irfan Basri, Mohd Azzuan Ahmad, Oviya Theverajan

Abstract


Knee osteoarthritis (KOA) is a common musculoskeletal disorder and a major cause of disability among aging populations. In Malaysia, the rising incidence of KOA underscores the need for culturally sensitive healthcare strategies. Yet, limited evidence exists on how Malay adults experience and manage KOA. Understanding these perspectives is critical for developing effective and culturally appropriate interventions. This study aimed to explore the attitudes, perceptions, and sociocultural influences on KOA experiences and management among Malay adults in Malaysia through a mixed-methods approach. Ten purposively sampled Malay adults aged 45-70 years with clinically diagnosed KOA were recruited from a tertiary hospital. Quantitative data were collected using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the 36-Item Short Form Health Survey (SF-36). Qualitative data were obtained through in-depth one-on-one semi-structured interviews and analyzed thematically. Findings revealed four major themes: (1) physical limitations and emotional burden affecting daily functioning, (2) mixed attitudes toward physiotherapy with selective use of conventional and traditional treatments, (3) sociocultural beliefs linking KOA to aging and divine will, shaped by family roles, and (4) religious adaptations and spiritual coping strategies that supported emotional resilience, with participants prioritizing independence over cure. Quantitative scores demonstrated wide variation in symptom severity, functional limitation, and quality of life, complementing qualitative insights. Overall, KOA substantially affects the physical, emotional, and sociocultural well-being of Malay adults. Interventions that integrate medical management with religious practices, family support, and culturally sensitive education are essential to enhance care and treatment adherence in this population.


Full Text:

PDF

References


Abdullah, J. M., Ismail, A., & Yusoff, M. S. B. 2024. Healthy Ageing in Malaysia by 2030: Needs, Challenges and Future Directions. Malaysian Journal of Medical Sciences 31(4): 1–13.

Ahmad, M. A., Ajit Singh, D. K., Qing, C. W., Ab. Rahman, N. N. A., Mohd Padzil, F. A. & Muhammad Hendri, E. N. 2018. Knee osteoarthritis and its related issues: Patients’ perspective. Malaysian Journal of Health Sciences 16(SI):171-177.

Ahmed, S. K., Mohammed, R. A., Nashwan, A. J., Ibrahim, R. H., Abdalla, A. Q., M. Ameen, B. M., & Khdhir, R. M. 2025. Using thematic analysis in qualitative research. Journal of Medicine, Surgery, and Public Health 6: 100198.

Alahmed, S. K., Mohyeldin, A. M., Alshammari, A., Alshammari, Z. F., Alhamdi, R. A., Alghaslan, S. A., Alshammari, H. F., Alshamry, F. F., Alshammari, A. H., & Alhamdi, M. S. 2023. Knowledge and Awareness Regarding Osteoarthritis and Its Factors in Hail Region, Saudi Arabia. Cureus 15(3): e36557.

Allen, K. D. 2010. Racial and ethnic disparities in osteoarthritis phenotypes. Current Opinion in Rheumatology 22(5): 528–532.

Baetz, M., & Bowen, R. 2008. Chronic pain and fatigue: Associations with religion and spirituality. Pain Research and Management 13(5): 383–388.

Callahan, L. F., Cleveland, R. J., Allen, K. D., & Golightly, Y. 2021. Racial/Ethnic, Socioeconomic, and Geographic Disparities in the Epidemiology of Knee and Hip Osteoarthritis. Rheumatic Disease Clinics of North America 47(1): 1–20.

Chia, Y. C., Beh, H. C., Ng, C. J., Teng, C. L., Hanafi, N. S., Choo, W. Y., and Ching, S. M. 2016. Ethnic differences in the prevalence of knee pain among adults of a community in a cross-sectional study. BMJ Open 6(12): e011925.

Chokkhanchitchai, S., Tangarunsanti, T., Jaovisidha, S., Nantiruj, K., and Janwityanujit, S. 2010. The effect of religious practice on the prevalence of knee osteoarthritis. Clinical Rheumatology 29(1): 39–44.

Chong, C. T., Lai, W. K., Mohd Sallehuddin, S., and Ganapathy, S. S. 2023. Prevalence of overweight and its associated factors among Malaysian adults: Findings from a nationally representative survey. PLoS One 18(8): e0283270.

Contartese, D., Tschon, M., De Mattei, M., and Fini, M. 2020. Sex Specific Determinants in Osteoarthritis: A Systematic Review of Preclinical Studies. International Journal of Molecular Sciences 21(10): 1–19.

Courties, A., Kouki, I., Soliman, N., Mathieu, S., and Sellam, J. 2024. Osteoarthritis year in review 2024: Epidemiology and therapy. Osteoarthritis and Cartilage 32(11): 1397–1404.

Cui, A., Li, H., Wang, D., Zhong, J., Chen, Y., and Lu, H. 2020. Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine 29–30: 100587.

Damen, J., van Rijn, R. M., Emans, P. J., Hilberdink, W., Wesseling, J., Oei, E. H. G., and Bierma-Zeinstra, S. M. A. 2019. Prevalence and development of hip and knee osteoarthritis according to American College of Rheumatology criteria in the CHECK cohort. Arthritis Research and Therapy 21(1): 4.

Eberly, L., Richter, D., Comerci, G., Ocksrider, J., Mercer, D., Mlady, G., Wascher, D., and Schenck, R. 2018. Psychosocial and demographic factors influencing pain scores of patients with knee osteoarthritis. PLoS One 13(4): e0195075.

Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdollahi, A., and Abdullahi, A. 2024. Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet 403(10440): 2133–2161.

Ganasegeran, K., Menke, J. M., Challakere Ramaswamy, V. M., Abdul Manaf, R., Alabsi, A. M., and Al-Dubai, S. A. 2014. Level and determinants of knowledge of symptomatic knee osteoarthritis among railway workers in Malaysia. BioMed Research International 2014: 370273.

Hennink, M., and Kaiser, B. N. 2022. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Social Science and Medicine 292: 114523.

Li, E., Tan, J., Xu, K., Pan, Y., and Xu, P. 2024. Global Burden and Socioeconomic Impact of Knee Osteoarthritis: A Comprehensive Analysis. Frontiers in Medicine 11: 1–12.

Mat, S., Jaafar, M. H., Ng, C. T., Sockalingam, S., Raja, J., Kamaruzzaman, S. B., Chin, A. V., Abbas, A. A., Chan, C. K., Hairi, N. N., Othman, S., Cumming, R. G., Tey, N. P., and Tan, M. P. 2019. Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoarthritis symptoms in older Malaysians. PLoS One 14(11): e0225075.

Mundermann, A., Nüesch, C., Ewald, H., and Jonkers, I. 2024. Osteoarthritis year in review 2024: Biomechanics. Osteoarthritis and Cartilage 32(12): 1530–1541.

Musa, A. F., Yasin, M. S. M., Smith, J., Yakub, M. A., and Nordin, R. B. 2021. The Malay version of SF-36 health survey instrument: testing data quality, scaling assumptions, reliability and validity in post-coronary artery bypass grafting (CABG) surgery patients at the National Heart Institute (Institut Jantung Negara, IJN), Kuala Lumpur. Health and Quality of Life Outcomes 19(1): 50.

Reyes, A. M., and Katz, J. N. 2021. Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management. Rheumatic Disease Clinics of North America 47(1): 21–40.

Roos, E. M., and Lohmander, L. S. 2003. The Knee Injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health and Quality of Life Outcomes 1(1): 64.

Sathiyamoorthy, T., Ali, S. A., and Kloseck, M. 2018. Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence. Journal of Community Health 43(4): 816–826.

Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care : journal of the International Society for Quality in Health Care 19(6): 349–357.

Wallis, J. A., Ackerman, I. N., Brusco, N. K., Kemp, J. L., Sherwood, J., Young, K., Jennings, S., Trivett, A., & Barton, C. J. 2020. Barriers and enablers to uptake of a contemporary guideline-based management program for hip and knee osteoarthritis: A qualitative study. Osteoarthritis and Cartilage Open 2(4): 100095.

Zulkifli, M. M., Kadir, A. A., Elias, A., Bea, K. C., & Sadagatullah, A. N. 2017. Psychometric Properties of the Malay Language Version of Knee Injury and Osteoarthritis Outcome Score (KOOS) Questionnaire among Knee Osteoarthritis Patients: A Confirmatory Factor Analysis. Malaysian Orthopaedic Journal 11(2): 7–14.


Refbacks

  • There are currently no refbacks.


Contact:

Editor-in-Chief

MALIM Jurnal Pengajian Umum Asia Tenggara

Pusat Pengajian Citra Universiti

Universiti Kebangsaan Malaysia

43600 UK­M Bangi, Selangor Darul Ehsan

MALAYSIA

E-mail: jmalim@ukm.edu.my

© Copyright Universiti Kebangsaan Malaysia