Living with osteoarthritis pain during COVID-19: perspectives of Black and White Canadians.

Objective: This study examines the lived experience and daily impact of hip and knee osteoarthritis pain in Black and White Canadians in the context of the COVID-19 pandemic.

Methods: An interpretative description approach was used. Recruitment was tailored to engage a diverse sample. During semi-structured, one-on-one interviews, participants reflected on their pain, its impact, and strategies for its management. A constant comparative approach was used. Standardized questionnaires collected gender, race, and OA severity to describe the sample.

Results: Thirty participants (15 Black, 15 White) with moderate knee and hip symptoms participated. OA pain was experienced on two continua. A continuum of control ranged from OA pain versus the participant controlling decisions to participate in daily activities. A continuum of certainty ranged from doubting versus feeling confident in the ability to manage OA pain. These continua intersected, creating quadrants. Pain controlling decisions and uncertainty led to a quadrant of feeling worn out. Pain controlling decisions and certainty resulted in a quadrant of unmet expectations. The participant controlling decisions combined with uncertainty was experienced as coping. The participant controlling decisions combined with certainty in managing OA pain created overcoming. Contextual factors that influenced these continua included COVID-19 restrictions, housing, employment, interactions with healthcare providers, and health literacy.

Conclusion: Participants' experiences of OA pain were linked to the sense of control in daily decisions and certainty in managing OA pain, reflecting concepts of locus of control and self-efficacy. Sociocultural factors, life experiences, and issues such as employment, housing, COVID-19 restrictions, and health literacy shaped these experiences.