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Are changes in pain, cognitive appraisals and coping strategies associated with changes in physical functioning in older adults with joint pain and chronic diseases?

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Abstract

Background

As the population ages, the number of people with chronic diseases increases. Frequently, older people suffer from joint pain together with other chronic diseases, which can lead to decreased physical functioning.

Aims

To investigate the associations of the changes in cognitive appraisals, coping strategies and pain with the change in physical functioning in older people, who have chronic pain and chronic diseases.

Methods

Elderly persons (n = 407, mean age 77 years, and 62% female), with self-reported joint pain and at least two chronic diseases, filled in questionnaires about cognitive appraisals, coping strategies, pain intensity and physical functioning at baseline, at 6- and 18-month follow-ups. The associations of change in physical functioning with changes in cognitive appraisals, coping strategies and pain were modelled using generalized estimating equations (GEE).

Results

Increase in pain, in negative thinking about the consequences of pain, and in activity avoidance and decrease in self-efficacy beliefs were associated with a decline in physical functioning.

Discussion

Observed mean changes were small but large inter-individual variability was seen. This shows that cognitive appraisals and coping strategies are malleable. Statistical model of change clarifies the direction of longitudinal associations.

Conclusions

The longitudinal findings suggest that joint pain, cognitive appraisals and coping strategies may determine physical functioning in older people who have chronic pain and comorbidity.

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References

  1. Pereira LSM, Sherrington C, Ferreira ML et al (2014) Self-reported chronic pain is associated with physical performance in older people leaving aged care rehabilitation. Clin Interv Aging 9:259

    Article  PubMed  PubMed Central  Google Scholar 

  2. van den Bussche H, Koller D, Kolonko T et al (2011) Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health 11:101

    Article  PubMed  PubMed Central  Google Scholar 

  3. Leveille SG, Bean J, Ngo L et al (2007) The pathway from musculoskeletal pain to mobility difficulty in older disabled women. Pain 128:69–77

    Article  PubMed  Google Scholar 

  4. Hoogendijk EO, van Hout HP, Heymans MW et al (2014) Explaining the association between educational level and frailty in older adults: results from a 13-year longitudinal study in the Netherlands. Ann Epidemiol 24:538–544e2.

    Article  PubMed  Google Scholar 

  5. Kroenke K (2003) Patients presenting with somatic complaints: epidemiology, psychiatric co-morbidity and management. Int J Methods Psychiatr Res 12:34–43

    Article  PubMed  Google Scholar 

  6. Stanton A, Revenson T, Tennen H (2007) Health psychology: psychological adjustment to chronic disease. Annu Rev Psychol 58:565–592

    Article  PubMed  Google Scholar 

  7. Lazarus R, Folkman S (1984) Stress, appraisal, and coping. Springer, New York

    Google Scholar 

  8. Hermsen LA, van der Wouden JC, Leone SS et al (2016) The longitudinal association of cognitive appraisals and coping strategies with physical functioning in older adults with joint pain and comorbidity: a cohort study. BMC Geriatr 16:1

    Article  CAS  Google Scholar 

  9. Asenlof P, Soderlund A (2010) A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: longitudinal data suggest disability and fear of movement are most important. Clin Rehabil 24:422–430

    Article  PubMed  Google Scholar 

  10. Karsdorp PA, Vlaeyen JW (2009) Active avoidance but not activity pacing is associated with disability in fibromyalgia. PAIN 147:29–35

    Article  PubMed  Google Scholar 

  11. Sardá J, Nicholas MK, Asghari A et al (2009) The contribution of self-efficacy and depression to disability and work status in chronic pain patients: a comparison between Australian and Brazilian samples. Eur J Pain 13:189–195

    Article  PubMed  Google Scholar 

  12. López-Martínez AE, Esteve-Zarazaga R, Ramírez-Maestre C (2008) Perceived social support and coping responses are independent variables explaining pain adjustment among chronic pain patients. J Pain 9:373–379

    Article  PubMed  Google Scholar 

  13. Nicholas MK, Asghari A, Blyth FM (2008) What do the numbers mean? Normative data in chronic pain measures. Pain 134:158–173

    Article  PubMed  Google Scholar 

  14. McCracken LM, Vowles KE, Gauntlett-Gilbert J (2007) A prospective investigation of acceptance and control-oriented coping with chronic pain. J Behav Med 30:339–349

    Article  PubMed  Google Scholar 

  15. Osborne TL, Jensen MP, Ehde DM et al (2007) Psychosocial factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain. Pain 127:52–62

    Article  PubMed  Google Scholar 

  16. Woby SR, Roach NK, Urmston M et al (2007) The relation between cognitive factors and levels of pain and disability in chronic low back pain patients presenting for physiotherapy. Eur J Pain 11:869–877

    Article  PubMed  Google Scholar 

  17. Linton SJ (2000) A review of psychological risk factors in back and neck pain. Spine 25:1148–1156

    Article  CAS  PubMed  Google Scholar 

  18. Rapp SR, Rejeski WJ, Miller ME (2000) Physical function among older adults with knee pain: the role of pain coping skills. Arthritis Care Res 13:270–279

    Article  CAS  PubMed  Google Scholar 

  19. Keefe FJ, Lefebvre JC, Egert JR et al (2000) The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: the role of catastrophizing. Pain 87:325–334

    Article  CAS  PubMed  Google Scholar 

  20. Somers TJ, Keefe FJ, Pells JJ et al (2009) Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manag 37:863–872

    Article  Google Scholar 

  21. Regier NG, Parmelee PA (2015) The stability of coping strategies in older adults with osteoarthritis and the ability of these strategies to predict changes in depression, disability, and pain. Aging Mental Health 19:1113–1122

    Article  PubMed  PubMed Central  Google Scholar 

  22. Hermsen LA, Leone SS, van der Windt DA et al (2011) Functional outcome in older adults with joint pain and comorbidity: design of a prospective cohort study. BMC Musculoskelet Disord 12:241

    Article  PubMed  PubMed Central  Google Scholar 

  23. Vander Zee KI, Sanderman R, Heyink JW et al (1996) Psychometric qualities of the RAND 36-Item Health Survey 1.0: a multidimensional measure of general health status. Int J Behav Med 3:104–122

    Article  CAS  Google Scholar 

  24. Smith BH, Penny KI, Purves AM et al (1997) The Chronic Pain Grade questionnaire: validation and reliability in postal research. Pain 71:141–147

    Article  CAS  PubMed  Google Scholar 

  25. Broadbent E, Petrie KJ, Main J et al (2006) The brief illness perception questionnaire. J Psychosom Res 60:631–637

    Article  Google Scholar 

  26. Jensen M, Keefe F, Lefebvre J et al (2003) One- and two-item measures of pain beliefs and coping strategies. Pain 104:453–469

    Article  PubMed  Google Scholar 

  27. Jensen MP, Keefe FJ, Lefebvre JC et al (2003) One- and two-item measures of pain beliefs and coping strategies. Pain 104(3):453–469

    Article  PubMed  Google Scholar 

  28. Kraaimaat FW, Evers AW (2003) Pain-coping strategies in chronic pain patients: psychometric characteristics of the pain-coping inventory (PCI). Int J Behav Med 10:343–363

    Article  PubMed  Google Scholar 

  29. Twisk JW (2013) Applied longitudinal data analysis for epidemiology: a practical guide. Cambridge University Press, Cambridge

    Book  Google Scholar 

  30. Pincus T, Vlaeyen JW, Kendall NA et al (2002) Cognitive-behavioral therapy and psychosocial factors in low back pain: directions for the future. Spine (Phila Pa 1976) 27:E133–E138

    Article  Google Scholar 

  31. Bandura A (1993) Perceived self-efficacy in cognitive development and functioning. Educ Psychol 28:117–148

    Article  Google Scholar 

  32. Benyon K, Hill S, Zadurian N et al (2010) Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review. Musculoskelet Care 8:224–236

    Article  Google Scholar 

  33. Vlaeyen JW, Linton SJ (2000) Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85:317–332

    Article  CAS  PubMed  Google Scholar 

  34. Leeuw M, Goossens ME, Linton SJ et al (2007) The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med 30:77–94

    Article  PubMed  Google Scholar 

  35. Pisters M, Veenhof C, van Dijk G et al (2014) Avoidance of activity and limitations in activities in patients with osteoarthritis of the hip or knee: a 5 year follow-up study on the mediating role of reduced muscle strength. Osteoarthr Cartil 22:171–177

    Article  CAS  PubMed  Google Scholar 

  36. Holla JF, Sanchez-Ramirez DC, van der Leeden M et al (2014) The avoidance model in knee and hip osteoarthritis: a systematic review of the evidence. J Behav Med 37:1226–1241

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The cohort study was funded by the Netherlands Organization for Health Research and Development (ZonMw). Report writing was supported by Mobility Grant of University of Jyväskylä’s Science Council (grant allocated to O. Ilves).

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Authors and Affiliations

  1. Faculty of Sport and Health Sciences, University of Jyvaskyla, P.O. Box 35, 40014, Jyvaskyla, Finland

    Outi E. Ilves

  2. Department of Rehabilitation Medicine, VU University Medical Center Amsterdam, Amsterdam, Netherlands

    Lotte A. H. Hermsen, Johannes C. van der Wouden, Marike van der Leeden, Martin Smalbrugge, Stephanie S. Leone, Henriette E. van der Horst & Joost Dekker

  3. Department of Rehabilitation Research, Reade, Centre of Rehabilitation and Rheumatology, Amsterdam, Netherlands

    Jasmijn F. M. Holla & Marike van der Leeden

  4. Department of Psychiatry, VU University Medical Center Amsterdam, Amsterdam, Netherlands

    Joost Dekker

Authors
  1. Outi E. Ilves
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  2. Lotte A. H. Hermsen
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  3. Johannes C. van der Wouden
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  4. Jasmijn F. M. Holla
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  5. Marike van der Leeden
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  6. Martin Smalbrugge
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  7. Stephanie S. Leone
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  8. Henriette E. van der Horst
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  9. Joost Dekker
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Corresponding author

Correspondence to Outi E. Ilves.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of human rights

The study was performed in accordance with the ethical standards as laid down in the Declaration of Helsinki. A study protocol was approved by the Medical Ethics Committee of the VU University Medical Center (Amsterdam, Netherlands).

Informed consent

From all the participants a written informed consent was obtained.

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Ilves, O.E., Hermsen, L.A.H., van der Wouden, J.C. et al. Are changes in pain, cognitive appraisals and coping strategies associated with changes in physical functioning in older adults with joint pain and chronic diseases?. Aging Clin Exp Res 31, 377–383 (2019). https://doi.org/10.1007/s40520-018-0978-x

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  • DOI: https://doi.org/10.1007/s40520-018-0978-x

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