Changes in self-efficacy and health status over 5 years: a longitudinal observational study of 306 patients with rheumatoid arthritis

Abstract

Objective: To investigate changes in self-efficacy and health status over 5 years in patients with rheumatoid arthritis (RA), the relationships between these changes, and the influence of baseline values on subsequent changes.

Methods: 306 adult patients with RA, born in 1926 or later, were examined by questionnaire in 1994 and again in 1999. We analyzed data regarding pain (visual analogue scale [VAS], Arthritis Impact Measurement Scale [AIMS2] symptom scale, Short Form-36 [SF-36] pain scale), fatigue (VAS, SF-36 vitality scale), mental distress (AIMS2 affect scale, SF-36 mental health scale) and self-efficacy (Arthritis Self-Efficacy Scales for pain and for other symptoms).

Results: On group level, all health status measures were numerically somewhat improved, and self-efficacy slightly reduced. Changes in self-efficacy and in corresponding health status measures were significantly correlated. For patients with above average educational level self-efficacy for pain at baseline was positively correlated to improvement in pain measures. Good mental health at baseline was correlated to improvement in self-efficacy for other symptoms, but only for patients with below average educational level.

Conclusion: Baseline self-efficacy seems to influence future level of perceived pain and baseline mental health status seems to influence future self-efficacy. These associations seem to be affected by level of education.