title: Coping styles and disability in patients with hand osteoarthritis.
abstract: OBJECTIVE
  Coping responses have been shown to determine health outcomes in chronic diseases. The aim of the study was to examine the role of joint-specific factors and coping styles on disability in patients with hand OA.
  
  
  METHODS
  Primary hand OA patients who consulted secondary care, underwent physical examination to assess the number of joints with bony joint enlargements, pain upon palpation, soft tissue swelling, deformities and limitations in motion. Coping styles were assessed with Coping with Rheumatic Stressors. Disability (score ≥5) was assessed by the Functional Index for Hand OA (possible score 0-30) cross-sectionally and after 1 year. With multivariate logistic regression, joint-specific variables and coping styles were associated with disability cross-sectionally and after 1 year, adjusted for age, sex and BMI.
  
  
  RESULTS
  A total of 314 patients (88% women, mean age 61.4 years) were included in the cross-sectional analyses; 68% were considered as disabled. Longitudinal data after 1 year were available in 173 patients (71% disabled). In multivariate analysis including all joint-specific factors, only painful joints and joints with limitations in motion were associated with disability. Disadvantageous scores for the coping scales (comforting cognitions, decreasing activity and pacing) were positively associated with disability cross-sectionally. Disability after 1 year was only associated with the coping scales decreasing activity and pacing. Joint-specific factors were also associated with disability, independent of coping styles.
  
  
  CONCLUSIONS
  In patients with hand OA, joint-specific factors and coping styles decreasing activity and pacing were both associated with disability. Our results suggest that interventions should aim at joint-specific complaints as well as changing coping styles to improve functional outcome.
authors.affiliation: Department of Rheumatology, r.liu@lumc.nl.
authors.forename: Rani
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Rheumatology.
authors.forename: Wendy
authors.initials: W
authors.lastname: Damman
authors.affiliation: Department of Medical Psychology and.
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Frits R
authors.initials: FR
authors.lastname: Rosendaal
authors.affiliation: Department of Rheumatology.
authors.forename: Margreet
authors.initials: M
authors.lastname: Kloppenburg
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000368:Aged; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D050823:Hand Joints / Q000503:physiopathology; D018737:Hand Strength; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010003:Osteoarthritis / Q000503:physiopathology* / Q000523:psychology* / Q000628:therapy; D010147:Pain Measurement; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
keywords: CORS; coping; disability; hand; osteoarthritis