Psychosocial interventions can help patients manage pain, reduce depression and anxiety, and improve social and leisure participation. These interventions, provided by trained nurses, social workers, and psychologists, educate patients about the important role thoughts and behaviors play in managing pain and mood, and show patients how to use coping skills, such as relaxation, imagery, activity-rest cycling, and cognitive restructuring.
Surgical interventions
Most patients with OA will not need a total joint replacement, which is indicated for patients with knee or hip OA who have pain at night that does not respond to NSAIDs, have difficulty performing ADLs, and have significant problems with mobility and working. Total joint replacements have positive results in many patients. (See Hip replacement.) The American Academy of Orthopaedic Surgeons provides extensive online information about total knee (orthoinfo.aaos.org/en/treatment/total-knee-replacement) and hip replacement (orthoinfo.aaos.org/en/treatment/total-hip-replacement).
Evidence-based care
OA management is multifaceted and includes nonpharmacologic, pharmacologic, and surgical interventions. As evidence grows, clinical guidelines will be updated. Nurses should stay alert for updates so that they can incorporate the latest recommendations along with their clinical expertise in conjunction with patient values and preferences to provide evidence-based patient care. (See OA resources.)
OA resources

The authors work at the University of Pittsburgh school of nursing in Pittsburgh, Pennsylvania. Elizabeth A. Schlenk is an associate professor and Xiaojun Shi is a PhD student.
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