Multiple psychological factors are associated with poorer functioning in a sample of community-dwelling knee osteoarthritis patients

J Clin Rheumatol. 2014 Aug;20(5):261-7. doi: 10.1097/RHU.0000000000000123.


Background: Knee osteoarthritis (OA) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people. There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients, particularly with respect to the surgery outcome. Less is known about psychological factors among community-dwelling patients with knee OA.

Objectives: We aimed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological questionnaires.

Methods: In the cross-sectional baseline setting of a prospective, randomized controlled intervention study, 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included. They completed a comprehensive set of psychological questionnaires, including measures of resources and coping, fear and catastrophizing, and distress.

Results: In cross-sectional comparisons, pain self-efficacy, fear of movement, pain catastrophizing, and elevated anxiety were associated with pain and a poorer functional ability. In logistic regression analysis, independent association was seen between pain self-efficacy and poorer functioning. Knee OA patients also reported elevated levels of anxiety.

Conclusions: The results reveal that both pain self-efficacy and negatively charged emotion and expectations toward pain are important factors when dealing with knee OA patients. Failure to consider these will probably contribute to prolonged disability and further pain. The results call for the routine assessment of multiple psychological factors in knee OA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / epidemiology
  • Anxiety / prevention & control
  • Catastrophization / psychology
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Geriatric Assessment*
  • Humans
  • Independent Living / psychology*
  • Independent Living / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnosis
  • Osteoarthritis, Knee / psychology*
  • Osteoarthritis, Knee / therapy
  • Pain / psychology*
  • Pain Measurement
  • Prognosis
  • Psychology
  • Range of Motion, Articular / physiology*
  • Risk Assessment
  • Sampling Studies
  • Self Efficacy
  • Severity of Illness Index