Olsson CB1,2, Ekelund J3, Degerstedt Å4, Thorstensson C5,6
1Karolinska Institutet, Neurobiology, Care Sciences and Society, Stockholm, Sweden, 2Academic Primary Healthcare Centre, Stockholm County Council, Stockholm, Sweden, 3Centre of Registers Västra Götaland, Gothenburg, Sweden, 4Team Aktiv Primärvårdsrehab, Stockholm, Sweden, 5Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden, 6Karolinska Institutet, Department of Medicine, Solna, Stockholm, Sweden
Background: Supporting patients with chronic conditions to self-manage and to make life style changes to obtain the best possible health and quality of life has become increasingly important. A core component in self-management is self-efficacy - a person's belief that they have the ability to perform a task to achieve a desired goal. Self-efficacy plays an important mediating role in a person adopting and maintaining behaviour changes and outcomes related to their health. Osteoarthritis is a lifelong condition that affects a large part of the population. Individuals with osteoarthritis need knowledge and support in handling self-care and in adopting a healthy and active lifestyle. In Sweden, a supported osteoarthritis self-management program has been developed and implemented nationwide to provide this.
Purpose: Describe the change in self-efficacy after a supported self-management osteoarthritis program.
Methods: An observational register-based study comprising 11,906 patients. Participants with hip or knee osteoarthritis self-reported at baseline and at 3 and 12 months follow-up. Self-efficacy for pain and other symptoms were assessed with the Arthritis Self-efficacy Scale. Change was analysed using a mixed-effect model for repeated measurements.
Results: In total, 9440 (pain subscale) and 9361 (symptom subscale) patients reported self-efficacy scores at baseline and at least one follow-up. The lowest self-efficacy at baseline was reported by patients with low education, walking difficulties, comorbidity and low physical activity level. Overall, the self-efficacy scores improved at the 3-month follow-up and returned to baseline at the 12-month follow-up. Younger age (pain and symptom subscales) and exercise (pain subscale) were associated with a greater increase in self-efficacy than older age and no exercise. Obesity (pain subscale) and hip problems (pain and symptom subscales) were associated with lower self-efficacy at baseline and a greater decrease at follow-up than normal weight and knee problems.
Conclusion(s): Change in self-efficacy was related to level of education, physical activity, mobility and comorbidity. In addition, hip problems or obesity were associated with greater difficulties in enhancing or maintaining self-efficacy.
Implications: An increased focus on patients with hip problems or obesity might help to improve outcomes after supported self-management programs for osteoarthritis.
Keywords: Osteoarthritis, exercise, patient education
Funding acknowledgements: This work did not have external funding.
Publication: Disability and Rehabilitation 2019 Jan 27:1-8, copyright Taylor and Francis, doi.org/10.1080/09638288.2018.1555616
Purpose: Describe the change in self-efficacy after a supported self-management osteoarthritis program.
Methods: An observational register-based study comprising 11,906 patients. Participants with hip or knee osteoarthritis self-reported at baseline and at 3 and 12 months follow-up. Self-efficacy for pain and other symptoms were assessed with the Arthritis Self-efficacy Scale. Change was analysed using a mixed-effect model for repeated measurements.
Results: In total, 9440 (pain subscale) and 9361 (symptom subscale) patients reported self-efficacy scores at baseline and at least one follow-up. The lowest self-efficacy at baseline was reported by patients with low education, walking difficulties, comorbidity and low physical activity level. Overall, the self-efficacy scores improved at the 3-month follow-up and returned to baseline at the 12-month follow-up. Younger age (pain and symptom subscales) and exercise (pain subscale) were associated with a greater increase in self-efficacy than older age and no exercise. Obesity (pain subscale) and hip problems (pain and symptom subscales) were associated with lower self-efficacy at baseline and a greater decrease at follow-up than normal weight and knee problems.
Conclusion(s): Change in self-efficacy was related to level of education, physical activity, mobility and comorbidity. In addition, hip problems or obesity were associated with greater difficulties in enhancing or maintaining self-efficacy.
Implications: An increased focus on patients with hip problems or obesity might help to improve outcomes after supported self-management programs for osteoarthritis.
Keywords: Osteoarthritis, exercise, patient education
Funding acknowledgements: This work did not have external funding.
Publication: Disability and Rehabilitation 2019 Jan 27:1-8, copyright Taylor and Francis, doi.org/10.1080/09638288.2018.1555616
Topic: Rheumatology; Disability & rehabilitation
Ethics approval required: Yes
Institution: University of Gothenburg
Ethics committee: The Regional Ethical Review Board, Gothenburg, Sweden
Ethics number: Dnr 1044-13
All authors, affiliations and abstracts have been published as submitted.
