The Good Life: Assessing the Relative Importance of Physical, Psychological, and Self-Efficacy Statuses on Quality of Well-Being in Osteoarthritis Patients
Background and Purpose. The purpose of the present study was to examine the interrelationships among physical dysfunction, self-efficacy, psychological distress, exercise, and quality of well-being for people with osteoarthritis. It was predicted that exercise would mediate the relationships between physical dysfunction, self-efficacy, psychological distress, and quality of well-being. Methods. Participants were 363 individuals with osteoarthritis who were 60 years of age or older. Data were collected from the baseline assessment period prior to participating in a social support and education intervention. A series of structural equation models was used to test the predicted relationships among the variables. Results. Exercise did not predict quality of well-being and was not related to self-efficacy or psychological distress; it was significantly related to physical dysfunction. When exercise was removed from the model, quality of life was significantly related to self-efficacy, physical dysfunction, and psychological distress. Conclusions. Engagement in exercise was directly related to physical functioning, but none of the other latent variables. Alternatively, treatment focused on self-efficacy and psychological distress might be the most effective way to improve quality of well-being. 1. The Interrelationships of Self-Efficacy, Psychological Distress, Physical Dysfunction, Exercise, and Quality of Well-Being among People with Osteoarthritis Osteoarthritis (OA) is a joint disorder, characterized by degeneration of cartilage creating joint pain and stiffness that worsen over time, most often affecting the hips and knees and leading to disability [1–3]. OA is the most common form of arthritis and affects close to 27 million Americans [4, 5]. After the age of 65, 60% of men and 70% of women experience OA [6]. OA is a leading cause of chronic pain, disability, and functional impairments [6]. Besides joint replacement, the most effective treatments available for OA consist of a combination of pharmacotherapy and behavioral self-management techniques [7]. Behavioral interventions have been shown to reduce the severity of symptoms associated with OA [8–10]. Behavioral treatments are largely focused on pain reduction and management and facilitation of mobility and physical functioning [11]. However, several factors affect the success of these treatments, including exercise, physical dysfunction, self-efficacy, and psychological distress [11]. These factors have been examined individually for their impact on quality of well-being in the OA population but have
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