Shifting Demographics in Knee Osteoarthritis: Psychosocial Needs of Younger and Poor Women Seeking Services from the Public Sector in Pakistan

Abstract

The study aimed to identify predictors of social support and emotional Well-being among poor women with knee osteoarthritis. Methods: Standardized measures were included in the survey. Reliability tests, independent sample t-tests, and multivariate logistic regression were applied. A total of 310 women seeking consultation at the out-patient department of a large public tertiary care hospital in Pakistan were sampled. The majority (54.8%) were younger than 45 years and reported lower emotional and spiritual Well-being, greater financial burden, and less social support. Lower odds of social support were associated with women having high pain severity ($\text{AOR} = 1.33$; $p = 0.002$), widowhood ($\text{AOR} = 1.65$; $p = 0.003$), rural residence ($\text{AOR} = 1.38$; $p = 0.003$), lack of education ($\text{AOR} = 1.60$; $p = 0.007$), lower emotional Well-being ($\text{AOR} = 1.48$; $p = 0.015$), and higher financial costs ($\text{AOR} = 1.56$; $p = 0.044$). Lower emotional Well-being was associated with higher financial costs ($\text{AOR} = 4.71$; $p = 0.001$), illiteracy ($\text{AOR} = 1.52$; $p = 0.001$), unemployment ($\text{AOR} = 1.79$; $p = 0.002$), rural residence ($\text{AOR} = 1.01$; $p = 0.004$), lower spiritual Well-being ($\text{AOR} = 1.45$; $p = 0.006$), and greater pain severity ($\text{AOR} = 1.28$; $p = 0.060$). The study recommends urgent socio-psychological interventions for poor women reliant on public health services, especially younger women, with implications for other developing countries. Younger women require greater support for childcare and early lifestyle modifications, while both age groups need interventions to improve health management, self-efficacy, and spiritual coping