Self-regulation in older Thai women with self-reported knee osteoarthritis: A path analysis

Factors influencing health status in older people with knee osteoarthritis

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. Increasing of self-efficacy and social support can then lead to improvement on health status. This study highlighted the effect of psychosocial factors on health status. It is necessary to develop a program to minimize pain catastrophizing, improve social support, and promote self-efficacy to improve the health status of older people with knee osteoarthritis.

Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence

With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding. A full scoping review was conducted across five databases resulting in 656 abstracts screened. All text was coded using the categorization matrix and resulting subthemes were identified. A total of 74 articles were analyzed with 23 subthemes identified across the nine categories. Four new perspectives emerged to support OA care for Asian populations: (1) the importance of family and peer assistance, (2) the importance of culturally specific activities, (3) distrust in western medicine, and (4) impact of positive coping mechanisms on health appraisals. While Asians are more susceptible to knee and hand OA because of their cultural lifestyle factors (e.g. squatting for chores, hygiene and religious activities), and traditional beliefs on OA management (e.g. traditional diet, topical oils, physical therapy), many do not present themselves for conventional treatments (e.g. surgery) until all traditional treatments are exhausted. The results suggest that cultural factors influence the uptake of OA management practices among Asians. Greater awareness of these cultural factors may improve diagnosis, treatment, and management of OA among Asian patients.