senior registrar in family medicine department , lagos university teaching hospital,Lagos,Nigeria
The relationship between pain coping and function status of knee OA elderly patients in Lagos,Nig
SUMMARY There has been a growing interest in the elderly population and their health challenges in the recent past . Osteoarthritis (OA) is the most common musculoskeletal condition affecting about 60-70% of the elderly population. OA of the knees is the most affected joint with a worldwide prevalence of 10% in adults above 60 years of age. OA of the knees has caused chronic pain, and often times, disability to the affected elderly. Biomedical treatment options have been the crux of care with their attendant complications. In the recent past, psychosocial management of the chronic pain from OA is being explored. This study was carried out to determine the ‘Relationship between Pain Coping Strategies and Functional Status of Elderly Patients with Knee Osteoarthritis attending Two Tertiary Hospitals in Lagos state’. The study was a hospital based cross sectional descriptive study carried out among consenting elderly patients aged 60 years and older who attended the orthopedic clinics of Lagos University Teaching Hospital (LUTH) and National Orthopedic Hospital Igbobi (NOHI). The functional status and pain coping strategies of the participants were assessed using the Western Ontario and McMaster Universities Osteoarthritis index and Vanderbilt Pain Coping Inventory. The data were analyzed using the Statistical Package for Social Sciences version 20. One hundred and five elderly participants aged between 60 and 112 years with a mean (SD) age of 68(±5) were studied. Fifty seven (54.3%) participants had mild pain intensity and only six (5.7%) had severe pains. Seventy four (70.5%) participants had a good functional status while, 31(29.5%) had an impaired functional status. There was a weak negative linear relationship between active pain coping strategies and functional status which was found to be statistically significant (r = -0.378, p<0.001) and a moderately positive linear relationship between passive coping strategies and functional status, which was also statistically significant (r = 0.469, p<0.001).
Abstract: There are a number of theoretical frameworks that attempt to explain how individuals may adjust to threats to health and serious physical illness. The three major paradigms that attempt to organize key components of health and adaptation to illness include the following: the biomedical model which emphasizes disease; psychological models of adaptation to illness; and biopsychosocial models with the latter two emphasizing health, functioning, and well-being. Each of these three major paradigms, including biomedical, psychosocial, and biopsychosocial frameworks, is discussed and critiqued in turn, and contributions and theoretical issues in terms of adjustment to chronic illness, particularly rheumatoid arthritis (RA), are highlighted. Furthermore, a biopsychosocial framework for conceptualizing adjustment to physical illness is proposed that incorporates elements from key existing biomedical and psychosocial models of adaptation to chronic physical health issues.
Pub.: 13 Jul '04, Pinned: 31 Jan '18
Abstract: Chronic diseases carry important psychological and social consequences that demand significant psychological adjustment. The literature is providing increasingly nuanced conceptualizations of adjustment, demonstrating that the experience of chronic disease necessitates adaptation in multiple life domains. Heterogeneity in adjustment is apparent between individuals and across the course of the disease trajectory. Focusing on cancer, cardiovascular disease, and rheumatic diseases, we review longitudinal investigations of distal (socioeconomic variables, culture/ethnicity, and gender-related processes) and proximal (interpersonal relationships, personality attributes, cognitive appraisals, and coping processes) risk and protective factors for adjustment across time. We observe that the past decade has seen a surge in research that is longitudinal in design, involves adequately characterized samples of sufficient size, and includes statistical control for initial values on dependent variables. A progressively convincing characterization of risk and protective factors for favorable adjustment to chronic illness has emerged. We identify critical issues for future research.
Pub.: 26 Aug '06, Pinned: 31 Jan '18
Abstract: This Review discusses physiological, emotional, behavioural, and cognitive aspects of psychological adjustment to chronic illness. Reviewing the reports of the past decade, we identify four innovative and promising themes that are relevant for understanding and explaining psychological adjustment. In particular, the emphasis on the reasons why people fail to achieve a healthy adjustment has shifted to the identification of factors that help patients make that adjustment. To promote psychological adjustment, patients should remain as active as is reasonably possible, acknowledge and express their emotions in a way that allows them to take control of their lives, engage in self-management, and try to focus on potential positive outcomes of their illness. Patients who can use these strategies have the best chance of successfully adjusting to the challenges posed by a chronic illness.
Pub.: 22 Jul '08, Pinned: 31 Jan '18