Factors Influencing Care-Seeking Behavior among Chinese Older Adults with Knee Osteoarthritis: A Mixed Methods Study

Early care-seeking behavior enables older adults to recognize initial symptoms, identify knee osteoarthritis, access appropriate healthcare, and improve health outcomes. A concurrent mixed-methods research design, incorporating cross-sectional and descriptive qualitative study phases, provides valuable insights into the factors influencing and perceptions of care-seeking behavior among Chinese older adults with knee osteoarthritis. Based on Andersen’s behavioral model, this study aimed to examine how factors such as knowledge of knee osteoarthritis symptoms, social support, stoicism, aging expectations, health insurance coverage, past experiences, pain severity, and comorbidities influence care-seeking behavior among 239 Chinese older adults with knee osteoarthritis across three communities in Dalian City, Liaoning Province, China. Data were collected using both questionnaires and in-depth interviews. Quantitative data were examined through descriptive statistics, Pearson's correlation analysis, and hierarchical multiple regression analysis, while qualitative data were analyzed through content analysis. The findings were synthesized using a side-by-side comparison approach. The converged results confirmed that strong social support and higher pain severity enhance professional care-seeking behavior, while a stoic attitude and lack of health insurance coverage diminished it. Additionally, qualitative findings highlighted unpleasant experiences in past care-seeking as barriers, whereas gaining more knowledge about knee osteoarthritis, having a comorbid condition, and expecting healthy aging emerged as facilitators. Insights from this theoretically grounded research can inspire and inform clinical nurses to promote early and professional care-seeking behavior, thereby preventing the progression of knee osteoarthritis.