Factors influencing health status in older people with knee osteoarthritis

Abstract

Aim: To examine a causal model of health status among older people with knee osteoarthritis. Methods: A cross-sectional, correlational design was used with a convenience sample of 220 older Thai people with knee osteoarthritis (mean age 68.96 years; SD = 6.22). Participants were asked to complete a demographic questionnaire, the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, The Medical Outcomes Study Social Support Survey, and the Arthritis Impact Measurement Scales 2-Short Form. Structural Equation Model was used to examine a hypothesized model. Results: Using Chi-square, hypothesized model was statistically nonsignificant. A model of health status fitted with the empirical data and explained 19.2% of variance. Pain catastrophizing had negative direct effect on self-efficacy and health status. Pain catastrophizing also had negative indirect effect on health status through self-efficacy. Self-efficacy and social support had positive direct effects on health status. However, pain-related fear had no direct or indirect effect on health status. Conclusion: Lower level of pain catastrophizing can improve self-efficacy.

Self-perceived burden, social support and pain, and kinesiophobia correlates in Chinese older adults with knee osteoarthritis: a cross-sectional survey

“…That is, the higher the level of social support for pain, the lower the degree of panic disorder, which is consistent with the results of Luque et al [56]. Social support and self-e cacy have a positive impact on patients and can improve health status [57]. After receiving support and encouragement from friends, elderly KOA patients can actively perform rehabilitation exercises and calmly overcome the fear of pain.…”

The Tampa Scale of Kinesiophobia

“…For our first hypothesis, the majority of the studies (94%) reported significant ( P <0.05) moderate to strong correlations between the TSK versions and other questionnaires evaluating constructs related to fear of pain and pain catastrophizing (PCS, PCS-4, FABQ, Patient Anxiety Symptoms Scale [PASS]) ( r TSK17 =0.42 to 0.86,26,40,42–44,52,62 r TSK13 =0.50 to 0.61,34,36,52,62,64 r TSK11 =0.72 to 0.7556,59 and r TSK 4 =0.49 to 0.7047,48). However, among all studies, 1 study of low risk of bias reported weak correlations between the TSK-11 and the PCS ( r TSK11 =0.34) 39. The second hypothesis was also confirmed as most of the different TSK versions showed weak to moderate correlations with disability ( r TSK17 =0.34 to 0.56,14,42,47,48,52 r TSK13 = 0.24 to 0.34,32,36,52 r TSK11 =0.48,45 r TSK4 =0.32 to 0.5447,48), pain intensity ( r TSK17 =0.18 to 0.74,14,26,51,52,55,59 r TSK13 =0.15 to 0.69,52,65 r TSK11 =0.27 to 4556,59), and anxiety and depression ( r TSK17 =0.27 to 0.50,26,44,47,48,55 r TSK13 =0.21 to 0.26,32,36 r TSK11 =0.28,38 r TSK4= 0.33 to 0.4447,48).…”

“…Indeed, Youngcharoen et al39 (ie,, low risk of bias study with a large sample size [n=200]) reported a weak correlation between TSK-11 and pain catastrophizing while correlations between the TSK-17 and 13 and pain catastrophizing construct were all moderate to strong. The population in which the validity of the TSK-11 was investigated cannot explain these results since both studies39,56 investigated similar populations but reported different correlation strengths. Indeed, while Youngcharoen et al39 investigated people with knee osteoarthritis (mean age 69 y old, mean pain duration 4.0±4.4 y) and reported low correlations with apparent constructs, Cai and colleagues56 reported strong correlations in people receiving total knee arthroplasty (mean age 69 y old, mean pain duration 5.7±5 y).…”

Osteoarthritis and fear

“…Since unresolved fear is an emotion linked to greater levels of pain and disability, exaggerated pain levels, persistent pain, deconditioning, physical disuse 57 and high dissatisfaction with joint replacement surgery, where it is in turn linked to fear avoidance, 59 failing to account for this potentially potent disease mediator or moderator both in the clinic as well as the hospital before or after surgery appears short sighted at best. Indeed, increasing data, although not all 60 support the idea that providers need to develop more skill at both anticipating possible perceptual vulnerabilities such as pain fears, as well as at addressing and uncovering the origins of this possible attribute of excess suffering among older adults with osteoarthritis of one or more joints. This could include the ability to empathetically discuss the nature of their disease with them, plus concerted efforts to offer tailored services directed towards improving their pain coping skills, and mitigating physical stresses, as well as mental stress associated factors such as anger, frustration, discouragement fear and helplessness, 61 as well as fears of partaking in physical therapy or pain producing activities.…”

“…In the meantime, it appears safe to conclude that the presence of high levels of intractable pain coupled with muscle weakness and joint instability, will potentially foster multiple pain-related fears that in turn, will greatly impact functional ability and independence, as well as feelings of depression and poor life quality 64 if untended or recognized, even in cases with minimal radiological damage. 15 As well, although Youngcharoen et al 60 found pain related fears of no import in influencing knee osteoarthritis health status, Skopaz et al 65 note both high anxiety and fear-avoidance beliefs to be related to poorer function, pain and osteoarthritis disability. As well fear of falling, balance, and physical capacity in the case of knee osteoarthritis appears to be significantly related.…”