The role of helplessness, outcome expectation for exercise and literacy in predicting disability and symptoms in older adults with arthritis.
OBJECTIVE
To examine the effect of outcome expectation for exercise (OEE), helplessness, and literacy on arthritis outcomes in 2 community-based lifestyle randomized controlled trials (RCTs) conducted in urban and rural communities with older adults with arthritis.


METHODS
Data from 391 participants in 2 RCTs were combined to examine associations of 2 psychosocial variables: helplessness and OEE, and literacy with arthritis outcomes. Arthritis outcomes namely, the Health Assessment Questionnaire-Disability Index (HAQ-DI) and arthritis symptoms pain, fatigue and stiffness Visual Analogue Scales (VAS), were measured at baseline and at the end of the interventions. Complete baseline and post-intervention data were analyzed using STATA version 9.


RESULTS
Disability after intervention was not predicted by helplessness, literacy, or OEE in the adjusted model. Arthritis symptoms after the intervention were all significantly predicted by helplessness at various magnitudes in adjusted models, but OEE and literacy were not significant predictors.


CONCLUSIONS
When literacy, helplessness, and OEE were examined as predictors of arthritis outcomes in intervention trials, they did not predict disability. However, helplessness predicted symptoms of pain, fatigue, and stiffness, but literacy did not predict symptoms.


CONCLUSIONS
Future sustainable interventions may include self-management components that address decreasing helplessness to improve arthritis outcomes.
Bhat
Anita A
AA
Department of Health Informatics, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA. abhat@mcg.edu
DeWalt
Darren A
DA
Zimmer
Catherine R
CR
Fried
Bruce J
BJ
Callahan
Leigh F
LF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000534:rehabilitation*; D001294:Attitude to Health; D004522:Educational Status; D015444:Exercise / Q000523:psychology; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome