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Adaptation to Early Knee Osteoarthritis: The Role of Risk, Resilience, and Disease Severity on Pain and Physical Functioning

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Radiographic joint changes are used to diagnose osteoarthritis; however, they alone do not adequately predict who experiences symptoms.

Purpose

To examine psychological risk and resilience factors in combination with an objective indicator of disease severity (knee X-rays) to determine what factors best account for pain and physical functioning in an early knee osteoarthritis (KOA) population.

Methods

Structural equation modeling was used to analyze data from 275 men and women with early KOA.

Results

Structural equation modeling yielded a fair to good fit of the data, suggesting that both risk and resilience were important in predicting pain and physical functioning over and above disease severity in the expected directions. Resilience’s effect on pain was mediated through self-efficacy, suggesting that higher self-efficacy was linked to lower pain and better physical functioning.

Conclusions

Results provide an integrative model of adjustment to early KOA and may be important to the prevention of disability in this population.

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Notes

  1. It was determined that the fit of the CFA model was worsened with the CES-D positive affect subscale in the model and was ultimately omitted. The CES-D negative affect subscale, on the other hand, improved the fit of the CFA model over and above the model fit with the full CES-D measure included. Therefore, this subscale was utilized in this study within the risk factor. No other variations of the measurement model were tested.

  2. This value was rescaled by dividing each value by 100 so that the range of this measure would be more similar to the other variables in the model.

  3. This value was rescaled by dividing each averaged value by 553 so that the range of this measure would be more similar to the other variables in the model.

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Authors and Affiliations

  1. University of California, San Diego, San Diego, CA, 92093-0738, USA

    Lisa Johnson Wright Ph.D.

  2. Arizona State University, Tempe, AZ, 85287-1104, USA

    Alex J. Zautra Ph.D.

  3. Department of Nutritional Sciences, University of Arizona, Tucson, AZ, 85721-0038, USA

    Scott Going Ph.D.

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  1. Lisa Johnson Wright Ph.D.
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  2. Alex J. Zautra Ph.D.
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  3. Scott Going Ph.D.
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Correspondence to Lisa Johnson Wright Ph.D..

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Wright, L.J., Zautra, A.J. & Going, S. Adaptation to Early Knee Osteoarthritis: The Role of Risk, Resilience, and Disease Severity on Pain and Physical Functioning. ann. behav. med. 36, 70–80 (2008). https://doi.org/10.1007/s12160-008-9048-5

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  • DOI: https://doi.org/10.1007/s12160-008-9048-5

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