title: The impact of self-efficacy on physical activity maintenance in patients with hip osteoarthritis - a mixed methods study.
abstract: Understanding motivational factors related to physical activity (PA) maintenance is essential in promoting long-term exercise benefits. This study explored the impact of self-efficacy (SE) on post-intervention PA maintenance in patients with hip osteoarthritis.
  
  
  
  An SE-theory based mixed-methods sub-study of a trial investigating the effects of 4 months supervised exercise in patients with hip osteoarthritis. Questionnaire data (n = 52; baseline and 12 months) on PA and SE (Arthritis Self-Efficacy Scale, ASES, score-range 10-100) were analysed (Mann-Whitney test) for differences in characteristics of maintainers and non-maintainers. Semi-structured individual interviews (n = 15; at 12-months follow-up) were analysed using directed content analysis.
  
  
  
  Compared to non-maintainers (n = 9; 17%) maintainers (n = 31; 60%) had improved (p < 0.01) in median scores of ASES (Pain: +12 versus -32 points; Function: +7 versus -9 points; Other Symptoms: +11 versus -26 points) from baseline to 12 months. Experiences of possessing required skills, inspiration by other participants, encouragement from physical therapists and altered interpretations of PA-induced physiological conditions contributed to increased SE and PA maintenance. Moreover, experienced symptoms, exercise outcome expectations and obligation towards the study influenced maintenance.
  
  
  
  SE contributes to understanding of post-intervention PA maintenance in patients with hip osteoarthritis. However, disease-related factors and clinical trial participation appears significant too. Implications for Rehabilitation Patients' perceived self-efficacy for physical activity contributes to the understanding of post-intervention physical activity maintenance in patients with hip osteoarthritis. Practitioners may benefit from incorporating the self-efficacy theory in the planning and execution of exercise interventions to promote post-intervention physical activity maintenance and long term health benefits. Post-intervention physical activity maintenance may be increased by focussing on the patients' exercise self-efficacy through verbal persuasion and support, disease-specific information and information on normal physiological responses to exercise combined with an individualised training progression to support experiences of success and achievement of desired outcomes.
authors.affiliation: a The University Hospitals Centre for Health Research, Copenhagen University Hospital , Copenhagen , Denmark ;
authors.forename: Nanna Maria
authors.initials: NM
authors.lastname: Hammer
authors.affiliation: b Musculoskeletal Rehabilitation Research Unit, Department Physical and Occupational Therapy & Institute of Sports Medicine Copenhagen , Bispebjerg & Frederiksberg Hospitals, University of Copenhagen , Copenhagen , Denmark ;
authors.forename: Theresa
authors.initials: T
authors.lastname: Bieler
authors.affiliation: b Musculoskeletal Rehabilitation Research Unit, Department Physical and Occupational Therapy & Institute of Sports Medicine Copenhagen , Bispebjerg & Frederiksberg Hospitals, University of Copenhagen , Copenhagen , Denmark ;
authors.forename: Nina
authors.initials: N
authors.lastname: Beyer
authors.affiliation: a The University Hospitals Centre for Health Research, Copenhagen University Hospital , Copenhagen , Denmark ;|c Department of Public Health , Section of Social Medicine, University of Copenhagen , Copenhagen , Denmark.
authors.forename: Julie
authors.initials: J
authors.lastname: Midtgaard
mesh_terms: D000368:Aged; D003718:Denmark; D015444:Exercise; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009042:Motivation; D015207:Osteoarthritis, Hip / Q000534:rehabilitation*; D010349:Patient Compliance; D020127:Recovery of Function; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: Exercise; hip; osteoarthritis; pain; self-efficacy scale