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01-10-2015 | Original Article

Self-efficacy in multimorbid elderly patients with osteoarthritis in primary care—influence on pain-related disability

Authors: Sven Schulz, Katja Brenk-Franz, Anne Kratz, Juliana J. Petersen, Steffi G. Riedel-Heller, Ingmar Schäfer, Siegfried Weyerer, Birgitt Wiese, Angela Fuchs, Wolfgang Maier, Horst Bickel, Hans-Helmut König, Martin Scherer, Hendrik van den Bussche, Jochen Gensichen, MultiCare Study Group

Published in: Clinical Rheumatology | Issue 10/2015

Abstract

The impact of self-efficacy on pain-related disability in multimorbid elderly patients in primary care is not known. The aim of our study was to analyze the influence of self-efficacy on the relation between pain intensity and pain-related disability, controlled for age and disease count, in aged multimorbid primary care patients with osteoarthritis and chronic pain. Patients were recruited in the German MultiCare study (trial registration: ISRCTN89818205). Pain was assessed using the Graded Chronic Pain Scale, and self-efficacy using the General Self-Efficacy Scale. We employed SPSS for statistical analysis. One thousand eighteen primary care patients were included in the study. Correlation analyses showed significant correlations between pain intensity and pain-related disability (r = 0.591, p < 0.001), pain intensity and general self-efficacy (r = 0.078, p < 0.05), and between general self-efficacy and pain-related disability (r = 0.153, p < 0.001). Multiple mediator analysis gives indications that self-efficacy partially mediates the relation between pain intensity and pain-related disability. In our results, we found little evidence that self-efficacy partially mediates the relation between pain intensity and pain-related disability in aged multimorbid primary care patients with osteoarthritis and chronic pain. Further research is necessary to prove the effect.

Wolff JL, Starfield B, Anderson G (2002) Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med 162(20):2269–2276CrossRefPubMed

Fuchs J, Busch M, Lange C, Scheidt-Nave C (2012) Prevalence and patterns of morbidity among adults in Germany. Results of the German telephone health interview survey German Health Update (GEDA) 2009. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 55(4):576–586. doi:10.1007/s00103-012-1464-9 CrossRef

Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L (2005) Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med 3(3):223–228. doi:10.1370/afm.272 PubMedCentralCrossRefPubMed

van den Bussche H, Koller D, Kolonko T, Hansen H, Wegscheider K, Glaeske G, von Leitner EC, Schafer I, Schon G (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. doi:10.1186/1471-2458-11-101 PubMedCentralCrossRefPubMed

Starfield B (2006) Threads and yarns: weaving the tapestry of comorbidity. Ann Fam Med 4(2):101–103. doi:10.1370/afm.524 PubMedCentralCrossRefPubMed

Schafer I, von Leitner EC, Schon G, Koller D, Hansen H, Kolonko T, Kaduszkiewicz H, Wegscheider K, Glaeske G, van den Bussche H (2010) Multimorbidity patterns in the elderly: a new approach of disease clustering identifies complex interrelations between chronic conditions. PLoS ONE 5(12):1–10. doi:10.1371/journal.pone.0015941 CrossRef

Gijsen R, Hoeymans N, Schellevis FG, Ruwaard D, Satariano WA, van den Bos GA (2001) Causes and consequences of comorbidity: a review. J Clin Epidemiol 54(7):661–674. doi:10.1016/S0895-4356(00)00363-2 CrossRefPubMed

Pereira D, Peleteiro B, Araujo J, Branco J, Santos RA, Ramos E (2011) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthr Cartil 19(11):1270–1285. doi:10.1016/j.joca.2011.08.009 CrossRefPubMed

Federal Statistical Office Germany (2006) Health, healthcare costs and personnel 2004. Statistisches Bundesamt, Wiesbaden

10.

Linaker CH, Walker-Bone K, Palmer K, Cooper C (1999) Frequency and impact of regional musculoskeletal disorders. Baillieres Best Pract Res Clin Rheumatol 13(2):197–215CrossRefPubMed

11.

Guccione AA, Felson DT, Anderson JJ, Anthony JM, Zhang Y, Wilson PW, Kelly-Hayes M, Wolf PA, Kreger BE, Kannel WB (1994) The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 84(3):351–358PubMedCentralCrossRefPubMed

12.

Hadjistavropoulos T, Herr K, Turk DC, Fine PG, Dworkin RH, Helme R, Jackson K, Parmelee PA, Rudy TE, Lynn Beattie B, Chibnall JT, Craig KD, Ferrell B, Fillingim RB, Gagliese L, Gallagher R, Gibson SJ, Harrison EL, Katz B, Keefe FJ, Lieber SJ, Lussier D, Schmader KE, Tait RC, Weiner DK, Williams J (2007) An interdisciplinary expert consensus statement on assessment of pain in older persons. Clin J Pain 23(1 Suppl):S1–S43. doi:10.1097/AJP.0b013e31802be869 CrossRefPubMed

13.

Helme RD, Gibson SJ (1999) Pain in older people. In: Crombie IK, Croft PR, Linton SJ, LeResche L, Von Korff M (eds) Epidemiology of pain. IASP Press, Seattle, WA, pp 103–112

14.

Katz N (2002) The impact of pain management on quality of life. J Pain Symptom Manag 24(1 Suppl):S38–S47CrossRef

15.

AGS Panel (2002) The management of persistent pain in older persons. J Am Geriatr Soc 50(6 Suppl):S205–S224

16.

Rejeski WJ, Craven T, Ettinger WH Jr, McFarlane M, Shumaker S (1996) Self-efficacy and pain in disability with osteoarthritis of the knee. J Gerontol B Psychol Sci Soc Sci 51(1):24–29CrossRef

17.

von Korff M, Ormel J, Keefe FJ, Dworkin SF (1992) Grading the severity of chronic pain. Pain 50(2):133–149. doi:10.1016/0304-3959(92)90154-4, 50CrossRef

18.

Turk DC, Okifuji A (2002) Psychological factors in chronic pain: evolution and revolution. J Consult Clin Psychol 70(3):678–690CrossRefPubMed

19.

Ormrod JE (2006) Educational psychology: developing learners, 5th edn. Pearson/Merrill Prentice Hall, Upper Saddle River, N.J

20.

van Dijk GM, Dekker J, Veenhof C, van den Ende CH (2006) Course of functional status and pain in osteoarthritis of the hip or knee: a systematic review of the literature. Arthritis Rheum 55(5):779–785. doi:10.1002/art.22244 CrossRefPubMed

21.

Arnstein P, Caudill M, Mandle CL, Norris A, Beasley R (1999) Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain 80(3):483–491CrossRefPubMed

22.

Denison E, Asenlof P, Lindberg P (2004) Self-efficacy, fear avoidance, and pain intensity as predictors of disability in subacute and chronic musculoskeletal pain patients in primary health care. Pain 111(3):245–252. doi:10.1016/j.pain.2004.07.001 CrossRefPubMed

23.

Turner JA, Ersek M, Kemp C (2005) Self-efficacy for managing pain is associated with disability, depression, and pain coping among retirement community residents with chronic pain. J Pain 6(7):471–479CrossRefPubMed

24.

Bayliss EA, Ellis JL, Steiner JF (2009) Seniors’ self-reported multimorbidity captured biopsychosocial factors not incorporated into two other data-based morbidity measures. J Clin Epidemiol 62(5):550–557. doi:10.1016/j.jclinepi.2008.05.002 PubMedCentralCrossRefPubMed

25.

Schuz B, Wurm S, Warner LM, Ziegelmann JP (2012) Self-efficacy and multiple illness representations in older adults: a multilevel approach. Psychol Health 27(1):13–29. doi:10.1080/08870446.2010.541908 CrossRefPubMed

26.

Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown BW Jr, Bandura A, Gonzalez VM, Laurent DD, Holman HR (2001) Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care 39(11):1217–1223CrossRefPubMed

27.

Lorig KR, Sobel DS, Ritter PL, Laurent D, Hobbs M (2001) Effect of a self-management program on patients with chronic disease. Eff Clin Pract 4(6):256–262PubMed

28.

Ersek M, Turner JA, Cain KC, Kemp CA (2008) Results of a randomized controlled trial to examine the efficacy of a chronic pain self-management group for older adults [ISRCTN11899548]. Pain 138(1):29–40. doi:10.1016/j.pain.2007.11.003 PubMedCentralCrossRefPubMed

29.

LeFort SM, Gray-Donald K, Rowat KM, Jeans ME (1998) Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain. Pain 74(2–3):297–306CrossRefPubMed

30.

Lorig KR, Mazonson PD, Holman HR (1993) Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis Rheum 36(4):439–446CrossRefPubMed

31.

Rosemann T, Joos S, Laux G, Gensichen J, Szecsenyi J (2007) Case management of arthritis patients in primary care: a cluster-randomized controlled trial. Arthritis Rheum 57(8):1390–1397. doi:10.1002/art.23080 CrossRefPubMed

32.

Fried LP (2000) Epidemiology of aging. Epidemiol Rev 22(1):95–106CrossRefPubMed

33.

Schafer I, Hansen H, Schon G, Hofels S, Altiner A, Dahlhaus A, Gensichen J, Riedel-Heller S, Weyerer S, Blank W, Konig HH, von dem Knesebeck O, Wegscheider K, Scherer M, van den Bussche H, Wiese B (2012) The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the MultiCare Cohort study. BMC Health Serv Res 12(1):89PubMedCentralCrossRefPubMed

34.

Schafer I, Hansen H, Schon G, Maier W, Hofels S, Altiner A, Fuchs A, Gerlach FM, Petersen JJ, Gensichen J, Schulz S, Riedel-Heller S, Luppa M, Weyerer S, Werle J, Bickel H, Barth K, Konig HH, Rudolph A, Wiese B, Prokein J, Bullinger M, von dem Knesebeck O, Eisele M, Kaduszkiewicz H, Wegscheider K, van den Bussche H (2009) The German MultiCare-study: Patterns of multimorbidity in primary health care—protocol of a prospective cohort study. BMC Health Serv Res 9:145. doi:10.1186/1472-6963-9-145 PubMedCentralCrossRefPubMed

35.

Jerusalem M, Schwarzer R (1992) Self-efficacy as a resource factor in stress appraisal processes. In: Schwarzer R (ed) Self-efficacy: thought control of action. Hemisphere, Washington, DC, pp 195–213

36.

von Korff M, Dworkin SF, LeResche L (1990) Graded chronic pain status: an epidemiologic evaluation. Pain 40(3):279–291CrossRef

37.

Smith BH, Penny KI, Purves AM, Munro C, Wilson B, Grimshaw J, Chambers WA, Smith WC (1997) The Chronic Pain Grade questionnaire: validation and reliability in postal research. Pain 71(2):141–147CrossRefPubMed

38.

Klasen BW, Hallner D, Schaub C, Willburger R, Hasenbring M (2004) [Validation and reliability of the German version of the Chronic Pain Grade questionnaire in primary care bach pain patients]. Psychosoc Med Doc07

39.

Baron RM, Kenny DA (1986) The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol 51(6):1173–1182CrossRefPubMed

40.

Levin JB, Lofland KR, Cassisi JE, Poreh AM, Blonsky ER (1996) The relationship between self-efficacy and disability in chronic low back pain patients. Int J Rehabil Health 2(1):10CrossRef

41.

Arnow BA, Blasey CM, Constantino MJ, Robinson R, Hunkeler E, Lee J, Fireman B, Khaylis A, Feiner L, Hayward C (2011) Catastrophizing, depression and pain-related disability. Gen Hosp Psychiatry 33(2):150–156. doi:10.1016/j.genhosppsych.2010.12.008 CrossRefPubMed

42.

Bandura A (1977) Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84(2):191–215CrossRefPubMed

43.

Bodenheimer T, Lorig K, Holman H, Grumbach K (2002) Patient self-management of chronic disease in primary care. JAMA 288(19):2469–2475CrossRefPubMed

44.

Wu SF, Kao MJ, Wu MP, Tsai MW, Chang WW (2011) Effects of an osteoarthritis self-management programme. J Adv Nurs 67(7):1491–1501. doi:10.1111/j.1365-2648.2010.05603.x CrossRefPubMed

45.

Mendelson AD, McCullough C, Chan A (2011) Integrating self-management and exercise for people living with arthritis. Health Educ Res 26(1):167–177. doi:10.1093/her/cyq077 CrossRefPubMed

46.

Hinz A, Schumacher J, Albani C, Schmid G, Brähler E (2006) Population representative standardization of a scale for general self-efficacy. Diagnostica 52:26–32CrossRef

47.

Bandura A (2006) Guide for constructing self-efficacy scales. In: Pajares F, Urdan T (eds) Self-efficacy beliefs of adolescents. CT: Information Age Publishing, Greenwich, pp 307–337

48.

van den Akker M, Buntinx F, Metsemakers JF, Roos S, Knottnerus JA (1998) Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases. J Clin Epidemiol 51(5):367–375. doi:10.1016/S0895-4356(97)00306-5 CrossRefPubMed

Title: Self-efficacy in multimorbid elderly patients with osteoarthritis in primary care—influence on pain-related disability
Authors: Sven Schulz
Katja Brenk-Franz
Anne Kratz
Juliana J. Petersen
Steffi G. Riedel-Heller
Ingmar Schäfer
Siegfried Weyerer
Birgitt Wiese
Angela Fuchs
Wolfgang Maier
Horst Bickel
Hans-Helmut König
Martin Scherer
Hendrik van den Bussche
Jochen Gensichen
MultiCare Study Group
Publication date: 01-10-2015
Publisher: Springer London
Published in: Clinical Rheumatology / Issue 10/2015
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-014-2766-0

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