Prognostic value of coping strategies in a community-based sample of persons with chronic symptomatic knee osteoarthritis

Abstract

Radiographic knee osteoarthritis (OA) is a highly prevalent condition that has been the focus of a number of studies identifying factors that are prognostic of continued or worsening pain and function. Although prior prognostic studies have identified a number of demographic, physical, and psychological factors that are predictive of outcome, minimal focus has been placed on pain coping skills as prognostic factors, despite cross-sectional evidence suggesting that pain coping skills are associated with pain and function in knee OA. The present study reports on the use of pain coping skills as prognostic factors for changes in pain and/or function over a 1-year period. Participants were drawn from the Osteoarthritis Initiative, a prospective longitudinal cohort study of persons recruited from the community who either had knee OA or were at high risk for developing knee OA. Data from the Coping Strategies Questionnaire were compared against 1-year change in pain, function, or both, using established criteria for defining whether the patient got better, worse, or stayed the same over the 1-year period. Results revealed a significant effect for praying/hoping, increased behavioral activities, and pain catastrophizing as prognostic of pain outcomes; ignoring pain and praying/hoping were prognostic of function outcomes; and increased behavioral activities and pain catastrophizing were prognostic of a combined pain and function outcome. The findings provide important new evidence regarding the potential clinical relevance of a number of pain coping responses hypothesized to influence future pain and function in persons with arthritis.

Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study

“…We considered 11 studies to be of sufficient quality. 2,6,15,16,18,19,28,34,39,41,42 None of the studies assessed the internal or external validity of their models.…”

“…2,6,15,16,21,27,28,30,34,41,42 Seven studies presented the discriminative power by calculating the AUC, which ranged from 0.69 to 0.90. 6,15,16,18,19,39,41 One study discussed the clinical usefulness of the prediction models by calculating the sensitivity, specificity, and likelihood ratios of each predictor (not for the complete model).…”

“…Alschuler et al 2 Belo et al 6 Currier et al 10 van Dijk et al 42 Holla et al 15 Holla et al 16 Kastelein et al 18 Kastelein et al 19 Maly et al 21 Peters et al 27 Rejeski et al 28 Rosemann et al 30 Schmitt [ research report ]…”

“…6,15,16,18,19,27,30,34,39,41 One study recruited patients from a military population, 10 2 studies from rehabilitation centers, 36,42 and 3 studies were community based. 2,21,28 The sample sizes of the studies varied from 54 to 1021 patients, with a mean sample size of 409.…”

A Clinician’s Perspective on Treating Patients Suffering from Insomnia and Pain

“…: guided imagery, controlled breathing, progressive muscle relaxation, etc.) (Masoudi et al 2013;Topcu and Findik 2012;Chen and Francis 2010;Lebovits 2007); stress management (Marchand 2012); biofeedback (Mora et al 2013); coping skills training (Alschuler et al 2013;Emery et al 2006); and, hypnosis (Adachi et al 2014).…”