Objective: To examine the association between changes in common sense models and changes in functional status over a 6-year follow-up in patients with osteoarthritis. Design: At baseline and follow... Show moreObjective: To examine the association between changes in common sense models and changes in functional status over a 6-year follow-up in patients with osteoarthritis. Design: At baseline and follow-up, osteoarthritis outpatients (N = 241) recruited from a university medical center completed the Illness Perception Questionnaire-Revised (IPQ-R), the Australian/Canadian Osteoarthritis Hand Index, and the Western Ontario and McMasters Universities Osteoarthritis Index. Also, their physician-assessed pain intensity, and biomedical, and clinical measures of medical severity of osteoarthritis were recorded. Main outcome measures: Functional disability, pain intensity. Results: Over 6 years, functional disability and pain intensity increased. The IPQ-R dimensions of timeline, personal control, and illness coherence became more negative, and emotional representations became less negative (i.e., more accepting). Patients identified as sharing a similar profile of negative changes on the IPQ-R had significantly worse functioning on 2 of 3 outcomes, independent of objectively measured osteoarthritis severity. Conclusions: Changes in illness perceptions were associated with changes in outcomes. Interventions to prevent increasingly negative patterns of illness perceptions over time, with an emphasis on strengthening control cognitions, may benefit functional status outcomes in patients with osteoarthritis. Show less
OBJECTIVE: To assess the impact of different subsets of symptomatic hand osteoarthritis (OA) on pain and disability. METHODS: From 308 hand OA patients a group with CMCJ symptoms only (group I, n... Show moreOBJECTIVE: To assess the impact of different subsets of symptomatic hand osteoarthritis (OA) on pain and disability. METHODS: From 308 hand OA patients a group with CMCJ symptoms only (group I, n=20) was identified as well as groups with symptoms at the interphalangeal joints (IPJs) only (group II, n=138), and symptoms at both sites (group III, n=150). Hand pain and function, assessed with the AUSCAN, were compared between groups using linear mixed models. Radiological OA was assessed using the Kellgren-Lawrence grading scale. RESULTS: Mean (SD) AUSCAN scores for group I, II and III were 23.1 (11.7), 18.3 (11.9) and 26.4 (12.5), respectively. After adjustment for age, gender, BMI, family effects and number of symptomatic hand joints, significant differences in AUSCAN scores of 7.4 (95% CI 1.8-13.0) between group I and II, and 5.7 (95% CI 2.7-8.6) between group II and III were found. AUSCAN scores were 5.8 (95% CI 3.1-8.6) higher for patients with versus patients without CMCJ symptoms. Kellgren-Lawrence scores did not differ between groups. CONCLUSION: In symptomatic hand OA, CMCJ OA contributes more to pain and disability than IPJ OA. Hence, treatment of CMCJ OA should be emphasized, even if it coincides with IPJ OA. Show less
