Mental health needs of patients with osteoarthritis based on a preference perspective: a mixed-methods study

To explore the characteristics and influencing factors of mental health needs in patients with osteoarthritis (OA) from a preference-based perspective, and to inform the development of tailored service strategies based on their needs and preferences.

From March to June 2024, 385 patients with OA were recruited from three tertiary hospitals in Changzhou using convenience sampling. Quantitative data were collected using the Hospital Anxiety and Depression Scale (HADS) and a self-developed Mental Health Needs and Preferences Questionnaire, and analyzed using multiple linear regression. Between July and August 2024, a subset of 28 participants was purposively selected from the same sample for semi-structured interviews, and the qualitative data were analyzed thematically.

Quantitative results showed that 56.1% of patients screened positive for anxiety or depressive symptoms. The highest reported need was for disease knowledge (4.21 ± 0.63), followed by symptom control (4.05 ± 0.71), emotion/behavior management (3.85 ± 0.89), and social/occupational functioning (3.42 ± 0.95). Regarding service preferences, patients preferred an orthopedic surgeon-led mode (68.3%), personalized face-to-face consultation (76.4%), pain management content (85.7%), and outpatient support (71.9%). Multiple regression analysis identified six significant influencing factors, including age and education level (P < 0.05). Qualitative findings elaborated on these patterns, revealing four themes: Psychological burden in illness experience, The Foundation of Self-Management: Needs for Health Literacy and Symptom Control, Psychological and Social Functioning Needs, Facilitators Shaping Service Engagement and Preferences. The consistency between quantitative scores and qualitative descriptions reinforced the validity of the identified need domains.

This mixed-methods study found a high prevalence of anxiety/depressive symptoms in OA patients and identified mental health needs across four dimensions: disease knowledge, symptom control, emotion/behavior management, and social/occupational functioning. Service preferences favored surgeon-involved, personalized, and pain-focused interventions. A multidisciplinary model integrating orthopedic and mental health professionals should be developed to provide personalized services aligned with patient preferences.

This study was approved by the Ethics Committee of Changzhou Second People's Hospital (approval No. [2024]KY003-01). The trial was prospectively registered with the Chinese Clinical Trial Registry (registration number MR-32-25-004771, registered on 28 March 2023).