Self-efficacy refers to a person's beliefs in their ability to organize, perform actions and face challenges in order to achieve aims and motivation. 1,2 It is not a matter of possessing certain capacities but is a belief that one has them or that one can acquire them through personal efforts (outcome expectancy). The strength of individuals' self-efficacy has an effect on how much effort and perseverance they will apply to achieve an aim. 3 Rheumatoid arthritis is a chronic autoimmune inflammatory disease characterized by pain and destruction of synovial joints that may lead to disability. 4 Epidemiological studies have estimated that the prevalence of rheumatoid arthritis in the adult population is 1%. It affects women three times as much as men and its incidence is highest among people aged between 35 and 65 years. 5 Several studies have found that among patients with rheumatoid arthritis, greater self-efficacy is a predictor for healthy behaviors, such as physical activity, healthy eating and strategies for dealing with pain. 6-9 Greater self-efficacy has also been correlated with lower daily pain, better emotional states, less stiffness, better functional capacity, better physical and mental wellbeing, less depression and better adherence to medication and other health recommendations. 10 It has also been associated with better health outcomes, including physical activity recommendations for rheumatoid arthritis patients. 6,7,11 In a recent review of the literature, negative correlations were found between self-efficacy and disability, pain, fatigue and duration of disease. 12 Studies have also suggested that self-efficacy is associated with the health outcomes of people with rheumatoid arthritis. In these studies, it was observed that the higher the self-efficacy was (which can be changed through educational programs), the higher the association that the patients had with better health status.

Importance: Hand osteoarthritis is a musculoskeletal problem that is associated with hand pain, stiffness, functional limitation, decreased grip strength, and reduced quality of life. Objective: To evaluate the effectiveness of nighttime orthoses on the second or third finger of the dominant hand in controlling pain in women with symptomatic osteoarthritis (OA) in the interphalangeal joint. Design: Randomized controlled trial. Setting: Outpatient clinic. Participants: Fifty-two women with symptomatic OA and presence of Heberden’s and Bouchard’s nodes, allocated randomly to the intervention group or the control group. Intervention: The intervention group used a nighttime orthosis on the second or third finger of the dominant hand. Both groups participated in an educational session. Outcomes and Measures: The following parameters were measured: pain (numerical rating scale, Australian/Canadian Osteoarthritis Hand Index), grip and pinch strength, function (Cochin Hand Functional Scale), and manual performance (Moberg Pick Up Test). Results: The intervention group showed a statistically significant improvement in pain (p < .001) and hand function. The improvement in pain correlated with Cochin Hand Functional Scale scores and the absence of Bouchard’s nodes in the third finger, which are predictors of the best prognosis for treatment with a nighttime orthosis. Conclusions and Relevance: This study demonstrates that nighttime orthoses are effective in reducing pain and lead to improvement in hand function in women with hand OA. They are therefore specifically recommended for nonpharmacological treatment of hand OA. What This Article Adds: Orthoses can be considered, together with manual exercises and joint protection, as an intervention to reduce symptoms and improve hand function in people with hand OA. This study is an important step in empowering occupational therapists to determine appropriate and effective intervention for clients with OA.

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