Regular participation in moderate-intensity physical activity (PA) is beneficial for patients with rheumatoid arthritis (RA); however, a large proportion of patients with RA are not physically... Show moreRegular participation in moderate-intensity physical activity (PA) is beneficial for patients with rheumatoid arthritis (RA); however, a large proportion of patients with RA are not physically active. In this dissertation, we describe the pilot-testing of an intervention to promote PA among patients with RA, as well as several preliminary studies which informed the development of the intervention. These preliminary investigations identified autonomous motivation, self-efficacy, PA goal achievement and use of self-regulation techniques as important predictors of PA behavior change. As such, and based on existing literature, motivational interviewing (MI) and self-regulation coaching (SR) were selected as intervention techniques which could impact upon these variables. In a randomized controlled trial, the combined MI+SR intervention led to increased autonomous motivation, self-efficacy and physical activity comp ared to a patient education control group over 32 weeks. Process analyses revealed that autonomous motivation and use of self-regulation skills explained the sustained increases in PA behavior, and that certain characteristics of MI sessions explained changes in autonomous motivation and PA. Despite increasing their PA, patients who received the intervention did not improve on any disease related variables. Practical implications of the findings are discussed. Show less
Knittle, K.P.; Gucht, V. de; Hurkmans, E.J.; Vlieland, T.P.M.V.; Peeters, A.J.; Ronday, H.K.; Maes, S. 2011
OBJECTIVE To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA). METHODS At... Show moreOBJECTIVE To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA). METHODS At baseline, 271 patients with RA were asked to specify a physical activity goal, and filled in questionnaires assessing physical activity, motivation, and self-efficacy for physical activity, arthritis pain, and quality of life. Six months later, patients indicated to what extent they had achieved their baseline physical activity goal and completed the same set of questionnaires. These data were used to construct multiple mediation models that placed physical activity and physical activity goal achievement as mediators between self-efficacy and motivation on one hand, and arthritis pain and quality of life on the other. RESULTS A total of 106 patients with RA completed both questionnaires. Self-efficacy at baseline predicted subsequent level of physical activity and achievement of physical activity goals. Goal achievement had a direct effect upon quality of life outcomes. Bootstrapping confidence intervals revealed indirect effects of self-efficacy upon arthritis pain and quality of life through goal achievement, but not through physical activity. CONCLUSION Higher levels of self-efficacy for physical activity increase the likelihood that patients will achieve their physical activity goals. Achievement of physical activity goals seems to be related to lower self-reported arthritis pain, and higher levels of quality of life. In practice, clinicians can foster self-efficacy and goal achievement by assisting patients in setting realistic and attainable exercise goals, developing action plans, and by providing feedback on goal progress. Show less
