The stability of coping strategies in older adults with osteoarthritis and the ability of these strategies to predict changes in depression, disability, and pain

Abstract

Objectives: Given the chronically painful, incurable nature of osteoarthritis, effective cognitive and behavioral coping strategies may be critical for older adults with the disease. Little is known about how and why coping changes over time, nor about stability of coping strategies in persons with osteoarthritis. The aims of this work were to examine the structure of coping in older adults with osteoarthritis, the association of coping strategies with well-being, the stability of coping over time, and its association with changes in well-being over the same period.

Method: In a cross-sectional study, 199 older adults with osteoarthritis of the knee were assessed at baseline and two-years’ follow-up. Items from two coping scales were factor analyzed, and Pearson's correlations and paired-samples t-tests assessed relative and absolute stability of the resultant coping strategies. CFA assessed the stability of the factor structure itself. Ordinary least-squares regression analyses examined the impact of change in coping on well-being.

Results: A five-factor coping solution emerged: stoicism, refocusing, problem-solving, wishful-thinking, and emotion-focused coping. The factor structure showed stability over the two-year period. Absolute stability of strategies varied, indicating that change in coping styles was possible.

Conclusion: Changes in coping style predicts future well-being; however, coping remains malleable with age and maladaptive strategies can be effectively targeted. Greater knowledge of the utility or maladaptive nature of a given strategy may help guide decisions about interventions for patients with osteoarthritis and encourage more adaptive coping styles.

Keywords:

• osteoarthritis
• coping stability
• chronic pain
• depression
• disability

Acknowledgments

We remember and are deeply indebted to M. Powell Lawton for conceptual guidance at the study's inception. We thank Lori Smith, James Hollender, Meredith Olderman, and Beth Chmar for collecting the data, as well as others who assisted in the project.

Disclosure statement

The authors declare that they have no conflict of interest with respect to their authorship or the publication of this article.

Additional information

Funding

This research was supported by NIMH [grant R01-MH51800] (P. Parmelee, PI) for research conducted at the Philadelphia Geriatric Center and the University of Pennsylvania.