Coping strategies and self-efficacy as predictors of outcome in osteoarthritis: a systematic review.
OBJECTIVE
Systematically to review the literature, investigating the prognostic value of self-efficacy and coping strategies used by adults with osteoarthritis (OA) recruited within the community or primary care.


METHODS
An online electronic search was performed from inception to August 2009, using EMBASE, CINAHL, PsycINFO and MEDLINE databases. A search of keywords and key authors was performed to find related articles, and experts in the field were contacted to identify additional literature. Three reviewers blindly assessed the quality of the included studies, using pre-determined criteria. Data on coping strategies and self-efficacy were extracted and tabulated.


RESULTS
Eight studies were identified and included in this review. Six of the papers were rated as being of acceptable methodological quality. Strong evidence was identified for the role of self-efficacy in predicting disability, but no evidence was found for the relationship between self-efficacy and pain. Although problem-solving coping had no effect on pain, there was weak evidence that active coping strategies predict increased pain and worsened mood. There was also weak evidence demonstrating that problem avoidance, wishful thinking, social withdrawal, self-criticism and turning to religion are predictors of depressed mood. This review also presents evidence for catastrophizing, self-efficacy and passive coping strategies as predictors of mood.


CONCLUSIONS
Coping strategies and self-efficacy are important prognostic factors for people with OA. This review highlights the need for further research to ascertain the predictive values of coping strategies that, to date, have been less well investigated. This may, in turn, result in a better understanding of the role of coping in OA and enable clinicians and patients to manage the condition more effectively.
Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK. kaybenyon@doctors.org.uk
Kay
K
Benyon
Susan
S
Hill
Natalie
N
Zadurian
Christian
C
Mallen
D000223:Adaptation, Psychological; D006233:Persons with Disabilities; D006801:Humans; D010003:Osteoarthritis / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D011340:Problem Solving; D011379:Prognosis; D020377:Self Efficacy; D016896:Treatment Outcome