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Abstract Number: 2103

Relationships Between Self-Efficacy, Outcome Expectancy, and Outcomes In Older Adults With Osteoarthritis Of The Knee and Hypertension: Baseline Results

Elizabeth A. Schlenk1, Deborah Crowley-Lisowski1, Sarah Twerski1, Alice Fallon1, Alyssa Sartore1, Susan Sereika1, Joan Rogers2, G. Kelley Fitzgerald3 and C. Kent Kwoh4, 1School of Nursing, University of Pittsburgh, Pittsburgh, PA, 2School of Health and Rehabilitation Sciences, Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, 3School of Health and Rehabilitation Sciences, Physical Therapy, University of Pittsburgh, Pittsburgh, PA, 4School of Medicine, Department of Medicine, Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pittsburgh, PA

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: geriatrics, hypertension, Osteoarthritis, physical activity and self-management

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Session Information

Session Title: ARHP Orthopedics, Low Back Pain and Rehabilitation: Rehabilitation Sciences

Session Type: Abstract Submissions (ARHP)

Background/Purpose: Staying Active with Arthritis (STAR), an intervention guided by Bandura’s Self-Efficacy Theory, is being investigated in an ongoing clinical trial of an individually delivered, home-based, 6-month lower extremity exercise and fitness walking program with older adults with osteoarthritis of the knee and hypertension treated with anti-hypertensive medication. We hypothesized that at baseline, self-efficacy and outcome expectancy (perceived therapeutic efficacy) would be related to relevant outcomes being measured in the STAR Study.

Methods: A descriptive correlational design was used for this study (N=107). Belief measures included McAuley’s Self-Efficacy Scales for Exercise and Barriers to Exercise; Lorig’s Arthritis Self-Efficacy Scales for Pain, Function, and Other Symptoms; and Perceived Therapeutic Efficacy Scale for arthritis (PTES-A) and hypertension (PTES-H). Outcome measures included systolic (SBP) and diastolic (DBP) blood pressure; 6-minute walk; Short Physical Performance Battery (SPPB); WOMAC Scales for Knee Function and Pain; SF36 Bodily Pain (BP) Scale, Physical Component Score (PCS), and Mental Component Score (MCS); Brief Fatigue Inventory (BFI); and quadriceps strength (QS) by MicroFET2 dynamometer. Multiple regression analyses were performed to identify significant independent predictors of the outcomes. Significance level was set at .05.

Results: Participants were on average 65 (SD=8) years of age, 73% (n=78) female, 76% (n=81) white, 42% (n=45) married, and 47% (n=50) employed, with 77% (n=81) having more than a high school education and 54% (n=48) having a family income <$50,000. There were no significant group differences in demographics or outcomes so the intervention and attention control groups were combined. Multiple regression analyses found that Exercise Self-Efficacy predicted 6-minute walk (p=.038) and SPPB (p=.022). Arthritis Self-Efficacy Pain was related to SBP (p=.002) and DBP (p=.001). Arthritis Self-Efficacy Function was predictive of DBP (p=.015), 6-minute walk (p<.0001), SPPB (p<.0001), PCS (p=.003), MCS (p=.021), and right (p=.030) and left (p=.020) knee QS. Arthritis Self-Efficacy Other Symptoms was associated with SBP (p=.032), DBP (p=.001), WOMAC Function (p=.008), WOMAC Pain (p=.023), SF-36 BP (p=.021), MCS (p<.0001), and BFI (p=.008). PTES-A predicted SBP (p=.031), WOMAC Function (p=.028), and WOMAC Pain (p=.035). PTES-H was related to WOMAC Pain (p=.019).

Conclusion: At baseline, Exercise Self-Efficacy predicted performance-based functional status as anticipated. Arthritis Self-Efficacy Pain was positively related to SBP and DBP, contrary to expectation. Arthritis Self-Efficacy Function and Other Symptoms predicted most outcomes in expected directions. Outcome expectancy predicted fewer outcomes. Future plans include examining the effect of the STAR intervention on self-efficacy and outcome expectancy and the extent to which self-efficacy and outcome expectancy act as mediators between the STAR intervention and outcomes.


Disclosure:

E. A. Schlenk,
None;

D. Crowley-Lisowski,
None;

S. Twerski,
None;

A. Fallon,
None;

A. Sartore,
None;

S. Sereika,
None;

J. Rogers,
None;

G. K. Fitzgerald,
None;

C. K. Kwoh,
None.

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