Social support has been shown to be positively related to an individual’s ability to cope with pain and their psychological adjustment to it. Studies have indicated that patients with higher levels of support, compared to those who receive less social support, report less pain and psychological dysfunction. Singapore will be hosting the World Congress on Pain in August 2010. This event aims to address the global problem of pain and how it is managed worldwide. One focus will be to brainstorm ideas for improving the management of chronic pain in developing countries.
The knee pain Singapore patients have access to a variety of healthcare providers and a wide range of treatment options for dealing with knee pain. The majority of therapists and general practitioners offer different treatment options. We do not have detailed information on the specific treatment options offered by each therapist or physician in Singapore. However, the support networks available to these patients are found to be more valuable than the treatment options themselves for chronic knee pain sufferers.
Support Networks for Knee Pain Patients
Online Communities
Several online communities have been formed to facilitate the exchange of information and resources among knee pain sufferers. The Yahoo Group is a site dedicated to knee replacement patients. It is an email forum which allows patients to talk about and discuss their experience and exchange information about knee replacement. Although not local, the information exchange and resources shared can be relevant to local patients and are invaluable. Another website is the Singapore Knee Pain Blog. Although not an online community, the blog shares information about knee pain and different treatment options and allows users to post comments and ask questions which may be answered by other patients or health professionals. An example of a useful information sharing platform is the blog. There are currently a limited number of Stryker navigation TKA being done in Singapore, but the blog offers a platform for post-operation patients to share and exchange information about their experience. Although these online communities can be useful platforms for patients to exchange information and share experiences, users must be wary of the credibility of certain information being shared. Information from these sources should not be taken to be accurate, and patients must always consult a health professional before taking any action.
Support Groups
Joint inflammation is a complex and varied condition. There are more than a hundred different forms of arthritis, but there may be hope for a specific arthritis support group one day. This would allow patients to explore more on their condition and the state of their so-called “wear and tear” in their joints and knees.
In addition, some support groups in the community focus on improving the conditions of patients with joint or bone-related problems. An example would be the Osteoporosis Society (Singapore). Ossified knee joints are common in elderly patients with osteoporosis and frequently lead to fractures. The society conducts regular exercise classes, talks, and nutrition workshops, which are beneficial to all individuals with bone or joint-related problems. These events and workshops are also effective in creating awareness on knee pain and other joint-related problems.
Support groups for patients with knee pain are active in hospitals around Singapore. The Department of Physiotherapy under Singapore General Hospital has a knee club that consists of patients with knee pain. The patients can interact and share their experiences, and there are talks conducted by physiotherapists and medical professionals on knee pain. NNI also has a Parkinson Society Support Group, which is catered for patients with Parkinson or parkinsonian features. This support group welcomes patients with movement disorders, including those with Parkinson, Multiple Sclerosis, Gait disorders, dizziness, and also knee pain. These support groups provide a platform for patients to share experiences and receive emotional encouragement.
Rehabilitation Centers
Patients with knee pain requiring rehabilitation can approach any Health Promotion Board (HPB) community hospitals for the necessary treatments. These hospitals include St Andrews Community Hospital and Bright Vision Hospital. Patients suffering from knee osteoarthritis (KOA) can have the option of going to the Osteoarthritis (OA) clinics to have their condition assessed and managed by a team of healthcare professionals consisting of knee pain specialist, nurses, physiotherapists, and occupational therapists. There are currently 4 OA clinics located in various restructured hospitals in different regions available to patients, and there are plans to expand these clinics to other hospitals in the near future. Some patients may prefer more convenience and opt for rehabilitation services in the private sector. It may be more costly, but patients can have a wide range of treatments tailored to their needs done by physiotherapists and other healthcare professionals in the comfort of a single room. These can be especially useful for post-operative patients. By the end of the treatment, all patients with KOA will be equipped with self-management knowledge and skills, for it is important for them to take a proactive role in managing their own conditions. This is in line with HPB’s Chronic Disease Management Programme in which KOA and knee pain is one of the diseases targeted.
Finding a Knee Pain Specialist in Singapore
Knee pain patients in Singapore have several options when seeking initial consultation and treatment. The most obvious choice would be to visit a hospital or see a specialist physician in a private clinic. All acute or chronic orthopaedic complaints can be dealt with at polyclinics. However, in order to find a knee specialist, the patient would likely need to visit a larger hospital with an orthopaedic surgery department. The major public hospitals in Singapore with orthopaedic departments include Singapore General Hospital, Tan Tock Seng Hospital, National University Hospital, and Changi General Hospital. Although it is often quicker and simpler to directly visit a hospital or clinic, some patients may still prefer to do some research before deciding on a specific specialist. An increasing number of patients are turning to the internet as a valuable resource in finding medical information. This trend has paved the way for online medical directories, which act as a search platform for patients to find a doctor. At Medical Singapore, visitors can find a specialist by browsing through our orthopaedic doctor listing. This is especially useful for patients who desire a second opinion, or who are seeking a specialist with expertise in a particular sub-specialty of knee care. Visitors can choose to find a doctor more specifically at the ‘orthopaedic surgery’ listing at the Singapore Orthopaedic Association website. This links to a page with a comprehensive list of orthopaedic surgeons in Singapore’s public and private sectors. Private sector doctors can also be found at the Bone Surgeon listing. Though it might be more convenient if all this information were centralized into a single database, this is already a good starting point for patients considering specialist care in the public or private sector. A similar resource also exists at the public Health Promotion Board website, aimed at guiding patients towards finding a doctor for specific health conditions.
Hospitals and Clinics
Singapore has many hospitals and clinics, ranging from private to public institutions. Seeking treatment in a government hospital will mean a longer waiting time, while treatment in a private clinic usually means higher medical fees. Funds from the hospital will be channeled to research on knee osteoarthritis, aiming to develop better treatment, while the clinics usually can provide well-specialized treatment for a particular knee condition. Regardless of cost, it is important to look for a knee pain specialist in these hospitals and clinics, which may improve medical outcome. If you have a family doctor whose opinion you value, ask for a referral to an orthopedic surgeon or rheumatologist who specializes in knee pain. If your knee pain is job-related, check whether your company has an approved medical institution where medical fees can be claimed through company insurance.
Online Directories
Most online directories list hospitals and clinics providing orthopaedic services generally, without specific mention of knee conditions. However, the Gleneagles and Mount Elizabeth group of hospitals and the Singapore National Orthopaedic Hospital are known to have a high concentration of many good orthopaedic surgeons. Specialists in the private hospitals are usually able to provide more personal and intimate links, more time and attention, and thus patient satisfaction is usually higher. However, consultation and surgery fees at these hospitals are generally higher than their counterparts in government-restructured hospitals. A vested interest in maintaining good customer rapport may sometimes lead to unnecessary investigations or treatment. For these businessmen attitudes to avoid “customer dissatisfaction,” certain treatment options and certain risks involved in surgery may not be fully explained.
A recent study has highlighted the impact of inactivity and diversity of coping strategies on health-related quality of life for knee OA patients. It would be expected that AOs with a cultural background that compares to traditional Chinese in Singapore would have much similarity to the Chinese sample in this study, and it is thus clear that OA has a great negative impact on these patients coming from traditional societies. Health care professionals working with these patients may need to focus specifically on increasing exercise and promoting certain coping strategies in order to improve their patients’ HRQOL. With the evidence provided by this sample, it points towards targeted interventions to modify coping strategies with the aim of increasing self-efficacy and reducing social activity limitations to improve HRQOL for knee OA patients in Singapore, particularly those coming from traditional societies.
In conclusion, there is evidence in this sample to suggest there are sociocultural differences between the East and the West, which will affect how one copes with osteoarthritis. These differences, particularly collective versus individualistic coping styles, have implications for how AOs would be best helped in coping with their condition. To understand what the differences are, and how Western culture has influenced Singapore, may give insights into the kind of strategies that are effective in giving support in this society. And to understand the coping methods of osteoarthritis patients within the sociocultural context can provide leads into the kinds of interventions that will make a difference to effective coping.