The longitudinal association of cognitive appraisals and coping strategies with physical functioning in older adults with joint pain and comorbidity: a cohort study

BMC Geriatrics

Research Article

Lotte A. H. Hermsen¹  Johannes C. van der Wouden¹  Martin Smalbrugge¹  Henriëtte E. van der Horst¹  Stephanie S. Leone²  Joost Dekker³ 

[1] Department of General Practice and Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands;Department of General Practice and Elderly Care Medicine, EMGO+ Institute for Health and Care Research, VU University Medical Center, van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands;Public Mental Health, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands;Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands;Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands;

关键词: Longitudinal;    Physical functioning;    Pain;    Older adults;    Psychosocial;    Coping;    Appraisal;    Musculoskeletal;   

DOI  :  10.1186/s12877-016-0204-7

 received in 2015-05-05, accepted in 2016-01-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSubstantial variation exists in physical functioning (PF) among patients with comparable pain severity, which may be partly explained by underlying psychological processes, like cognitive appraisal of pain and coping with pain. It remains unclear to what extent such determinants contribute to changes in PF over time, especially in older populations. Therefore, we examined longitudinal associations of cognitive appraisals and coping strategies with PF, in older adults with joint pain and comorbidity.MethodsA prospective cohort study among 407 older adults with joint pain and comorbidity provided data over 18 months, with 6 month time-intervals. We measured PF (RAND-36), five cognitive appraisals (consequences, concerns, emotional representations, self-efficacy, catastrophizing), four coping strategies (ignoring pain, positive self-statement, increasing activity levels, activity avoidance) and three time-dependent covariates; pain intensity, anxiety and depressive symptoms. Longitudinal associations were analyzed with Generalized Estimated Equations (GEE), by testing auto-regressive models, adjusted for covariates.ResultsMore negative thoughts about consequences of pain (β = -0.54, 95 % CI = -1.02; -0.06), more catastrophizing (β = -0.67, 95 % CI = -1.26; -0.07) and more activity avoidance (β = -0.32, 95 % CI = -0.57; -0.08) were significantly associated with subsequent deterioration in PF, whereas higher perceived self-efficacy (β = 0.22, 95 % CI = 0.12; 0.31) was associated with subsequent improvement in PF. Neither concerns, emotional representations, ignoring pain, positive self-statement nor increasing activity levels were longitudinally related to PF.ConclusionsMore negative thoughts about consequences of pain, more catastrophizing and more activity avoidance contributed to deteriorated PF, whereas higher perceived self-efficacy contributed to improved PF. This knowledge may contribute to future management of functional limitations in older adults with joint pain and comorbidity.

【 授权许可】

CC BY   
© Hermsen et al. 2016