Effect of a Positive Psychological Intervention on Pain and Functional Difficulty Among Adults With Osteoarthritis

Autor: Leslie R. M. Hausmann, Ada O. Youk, Ernest R. Vina, D. Scott Obrosky, Shauna E. McInnes, Rollin M. Gallagher, C. Kent Kwoh, Said A. Ibrahim, Debra K. Weiner, Genna T. Mauro
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: JAMA Network Open
ISSN: 2574-3805
Popis: Key Points Question Is positive psychology effective as a treatment for chronic arthritis pain and does it reduce race disparities in pain management? Findings In this randomized clinical trial involving 360 Veterans Affairs patients with chronic pain from osteoarthritis, a 6-week telephone-administered positive psychological intervention did not improve pain or functional difficulty vs a control program. No difference by race was found in the effect of the intervention. Meaning A telephone-administered positive psychological intervention was not associated with improvement in chronic pain or functional difficulty from osteoarthritis for either white or African American patients.
Importance Positive psychological interventions for improving health have received increasing attention recently. Evidence on the impact of such interventions on pain, and racial disparities in pain, is limited. Objective To assess the effects of a positive psychological intervention on pain and functional difficulty in veterans with knee osteoarthritis. Design, Setting, and Participants The Staying Positive With Arthritis Study is a large, double-blinded randomized clinical trial powered to detect race differences in self-reported pain in response to a positive psychological intervention compared with a neutral control intervention. Data were collected from 2 urban Veterans Affairs medical centers. Participants included non-Hispanic white and non-Hispanic African American patients aged 50 years or older with a diagnosis of osteoarthritis. Mailings were sent to 5111 patients meeting these criteria, of whom 839 were fully screened, 488 were eligible, and 360 were randomized. Enrollment lasted from July 8, 2015, to February 1, 2017, with follow-up through September 6, 2017. Interventions The intervention comprised a 6-week series of evidence-based activities to build positive psychological skills (eg, gratitude and kindness). The control program comprised similarly structured neutral activities. Programs were delivered via workbook and weekly telephone calls with interventionists. Main Outcomes and Measures The primary outcomes were self-reported pain and functional difficulty measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; range 0-100). Secondary outcomes included affect balance and life satisfaction. Results The sample included 180 non-Hispanic white patients and 180 non-Hispanic African American patients (mean [SD] age, 64.2 [8.8] years; 76.4% were male). Mean (SD) baseline scores for WOMAC pain and functional difficulty were 48.8 (17.6) and 46.8 (18.1), respectively. Although both decreased significantly over time (pain: χ23 = 49.50, P
This randomized clinical trial assesses the effects of a positive psychological intervention on pain and functional difficulty vs a control program in veterans with knee osteoarthritis and evaluates whether this management varies by race.
Databáze: OpenAIRE
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