A number of methods are used to assess symptoms in patients. For example, radiographic joint changes are used to diagnose osteoarthritis; however, they alone do not adequately predict who experiences symptoms. Wright and coworkers examined psychological risk and resilience factors in combination with an objective indicator of disease severity (knee X-rays) to determine what factors best account for pain and physical functioning in an early knee osteoarthritis (KOA) population. Structural equation modeling was used to analyze data from 275 men and women with early KOA. The approach yielded a fair to good fit of the data, suggesting that both risk and resilience were important in predicting pain and physical functioning over and above disease severity in the expected directions. Resilience's effect on pain was mediated through self-efficacy, suggesting that higher self-efficacy was linked to lower pain and better physical functioning.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: Wright and colleagues suggested their results provide an integrative model of adjustment to early KOA and may be important to the prevention of disability in this population. These are prudent conclusions, particularly with respect to the role of the patient in managing KOA.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The integrative model used in the study relied upon both medical and behavioral input. It suggested that you, if you have KOA, can make a contribution by performing self-management skills and developing the self-efficacy required to maintain your performance. It will be worth your sustained efforts.

LJ Wright et al. Adaptation to Early Knee Osteoarthritis: The Role of Risk, Resilience, and Disease Severity on Pain and Physical Functioning. Annals of Behavioral Medicine, August 21, 2008.