LAUSR

OBJECTIVE Reduced knee confidence is common in people with knee osteoarthritis and is likely to influence how people with knee osteoarthritis engage with movement and activities. However, there is conflicting evidence surrounding the association between confidence and function. This may be because knee confidence has been assessed via a single questionnaire item that was not developed for people with knee osteoarthritis, and thus may not provide an accurate nor comprehensive assessment of confidence in this population. A better understanding of knee confidence could inform a more thorough assessment of the construct both in clinical and research contexts. Therefore, the aim of this study was to explore the meaning of knee confidence from the perspective of people with knee osteoarthritis. METHODS Fifty-one people with a clinical diagnosis of knee osteoarthritis took part in a one-to-one semistructured interview. Interviews explored how each participant conceptualized knee confidence. Reflexive thematic analysis was selected as a flexible approach for identifying patterns of meaning across cases through a combination of data-driven and theory-informed coding of the transcribed data. RESULTS People with knee osteoarthritis conceptualized confidence with reference to 1 or more of 4 themes: (1) symptoms; (2) functional ability; (3) the internal structure of the knee; and (4) knowledge about knee osteoarthritis and its management. Each conceptualization of confidence was associated with present and future concerns. CONCLUSIONS As people with knee osteoarthritis conceptualize knee confidence in different ways, a single-item measure is unlikely to capture all of the aspects of this construct in this population. This may explain the conflicting evidence around the association between reduced knee confidence and function in people with knee osteoarthritis.