title: The role of helplessness, outcome expectation for exercise and literacy in predicting disability and symptoms in older adults with arthritis.
abstract: 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.
authors.affiliation: Department of Health Informatics, Medical College of Georgia, 1120 15th Street, Augusta, GA 30912, USA. abhat@mcg.edu
authors.forename: Anita A
authors.initials: AA
authors.lastname: Bhat
authors.forename: Darren A
authors.initials: DA
authors.lastname: DeWalt
authors.forename: Catherine R
authors.initials: CR
authors.lastname: Zimmer
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Fried
authors.forename: Leigh F
authors.initials: LF
authors.lastname: Callahan
mesh_terms: 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