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.
E. A. Schlenk,
G. K. Fitzgerald,
C. K. Kwoh,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/relationships-between-self-efficacy-outcome-expectancy-and-outcomes-in-older-adults-with-osteoarthritis-of-the-knee-and-hypertension-baseline-results/