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

Abstract

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. 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). 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. 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.