Self-Efficacy for Pain and Weight Management in Overweight/Obese Patients with Osteoarthritis:

1. Self-Efficacy for Pain and Weight Management in Overweight/Obese Patients with Osteoarthritis: Relations to Pain and Disability SIGNIFICANCE Jennifer J. Pells, Kim E. Dixon, James A. Blumenthal, Jessica M. Tucker, David S. Caldwell, Virginia B. Kraus, Daniel Schmitt, Ershela L. Sims, & Francis J. Keefe Duke University Medical Center METHODS RESULTS SUMMARY & CONCLUSIONS • Participants • 115 overweight/obese OA patients: • - 91 women, 24 men • - Mean age = 57.1 years (SD=10.0) • - Mean BMI = 34.1 (SD=4.5) • - 36% African American; 63% White • - Mean disease duration = 14.1 years (SD 8.4) • Converging evidence shows that Osteoarthritis (OA) is negatively impacted by increased body mass as a result of biomechanical, inflammatory, and cognitive-behavioral processes. • However, little is known about specific psychosocial factors that predict negative OA-related outcomes among overweight/obese OA patients. • Self-efficacy for managing OA pain, other arthritis symptoms, and physical function, and self-efficacy for resisting eating may be important factors in understanding differences in pain, physical disability, and psychological disability in this population. • Higher self-efficacy for pain and function, and lower BMI • were associated with lower pain scores. • Higher self-efficacy for function was associated with lower • physical disability. Older age and female gender also • predicted greater physical disability. • Higher self-efficacy for controlling other arthritis • symptoms and for resisting eating predicted lower • psychological disability. • Self-efficacy accounted for significant amounts of • variance in pain and disability even after controlling for • demographic and medical variables. • Arthritis-related self-efficacy emerged as a particularly • important factor in predicting OA pain and disability • among overweight/obese OA patients. • Findings suggest that interventions for overweight/obese • OA patients should target self-efficacy, and interventions • that combine weight management with pain coping skills • training may be most beneficial for this population. • Procedure • Patients completed all measures at a single time-point • Measures • Arthritis Self-Efficacy – measured by the Arthritis Self-Efficacy Scale (ASES; Lorig et al., 1989), which consists of three subscales to assess patients’ beliefs that they can decrease pain, control other arthritis symptoms, and perform daily activities • Eating Self-Efficacy – Patients’ perceived ability to resist eating across different situations was measured by the Weight Efficacy Life-style Questionnaire (Clark, Abrams, Niaura, Eaton, & Rossi, 1991). Average scores across situations were used. • Pain, Physical Disability, Psychological Disability – assessed by three subscales of the Arthritis Impact Measurement Scales (AIMS; Meenan, Gertman, & Mason, 1980). • Statisical Analyses • Hierarchical regression analyses were used to test the study hypotheses. Table 1. Regression analysis for Self-efficacy (ASES; WEL) and AIMS * p<.05 ** p<.01 ***p<.001 PURPOSE The purpose of this study was to: 1) examine contributions of arthritis-related self-efficacy and self-efficacy for eating to pain, physical disability, and psychological disability, 2) determine whether self-efficacy contributes to outcomes above and beyond the contributions of age, sex, body mass, and duration of OA. REFERENCES • Clark, M.M., Abrams, D.B., Niaura, R.S., Eaton, C.A., & Rossi, J.S. (1991). Self-efficacy in weight management. Journal of Consulting and Clinical Psychology, 59, 739-744. • Lorig, K., Chastain, R.L., Ung, E., Shoor, S., & Holman, H.R. (1989). Development and validation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis & Rheumatism, 32, 37-45. • Meenan, R.F., Gertman, P.M., & Mason, J.H. (1980). Measuring health status in arthritis: The arthritis impact measurement scales. Arthritis & Rheumatism, 23 (2), 146-152. • Corresponding author: Jennifer J. Pells, PhD, jennifer.pells@duke.edu HYPOTHESES • Arthritis-related self-efficacy would explain significant variance in OA pain and disability, even after controlling for important demographic and medical variables. • No a priori hypotheses regarding self-efficacy for eating were made. Figure 1. Contributions of Self-efficacy to Variance in AIMS Scores Research supported by NIH grant #1P01 AR50245-01