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This cross-sectional study examined the factors influencing physical activity among women with osteoarthritis of the knee. The Interaction Model of Client Health Behaviors was used as a theoretical framework to guide the study. The sample consisted of 242 female participants with osteoarthritis of the knee attending the outpatient department of a university hospital in Bangkok, Thailand. Data were collected using Personal Data Questionnaire, Modified Thai version of Western Ontario and McMaster Universities’ Osteoarthritis Index, Thai version of Catastrophizing Subscale of the Coping Strategies Questionnaire, Thai version of Fear-Avoidance Beliefs Questionnaire about Physical Activity modified for osteoarthritis of the knee, Revised Thai Multi-dimensional Scale of Perceived Social Support, and the Short Form of International Physical Activity Questionnaire. Data were analyzed using descriptive statistics and logistical regression.
The findings revealed that the mean age of the participants was 65.1 years and 60% had low physical activity. Body mass index and pain-related fear significantly influenced physical activity. However, age, knee pain, functional limitation, pain catastrophizing, and social support did not significantly influence physical activity. The implication for nursing practice from this finding is that nurses need to assess body mass index and identify barriers to performing physical activity among women with osteoarthritis. Any intervention program should include the benefit of weight reduction as well as strategies to reduce pain-related fear to increase their physical activity level.
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2. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis. Osteoarthritis and Cartilage. 2010;18(4):476-99.
3. World Health Organization. Global reccomendations on physical activity for health. Geneva, Switzerland: WHO; 2010.
4. International Physical Activity Questionnaire Group. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)- Short and Long Forms 2005 [cited 2014 18 October]. Available from: www.ipaq.ki.se.
5. Wallis JA, Webster KE, Levinger P, Taylor NF. What proportion of people with hip and knee osteoarthritis meet physical activity guidelines? A systematic review and meta-analysis. Osteoarthritis and Cartilage. 2013;21(11): 1648-59.
6. Chmelo E, Nicklas B, Davis C, Miller GD, Legault C, Messier S. Physical activity and physical function in older adults with knee osteoarthritis. Journal of physical activity & health. 2013;10(6):777-83.
7. Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM, et al. Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met? Arthritis Rheum. 2011;63(11):3372-82.
8. Rosemann T, Kuehlein T, Laux G, Szecsenyi J. Factors associated with physical activity of patients with osteoarthritis of the lower limb. Journal of Evaluation in Clinical Practice. 2008;14(2):288-93.
9. Lee J, Song J, Hootman JM, Semanik PA, Chang RW, Sharma L, et al. Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis. Arthritis Care Res. 2013;65(1): 53-61.
10. Rosemann T, Kuehlein T, Laux G, Szecsenyi J. Osteoarthritis of the knee and hip: a comparison of factors associated with physical activity. Clin Rheumatol. 2007;26(11): 1811-7.
11. Cox CL. An interaction model of client health behavior: theoretical prescription for nursing. Advances in Nursing Science. 1982;5(1):41-56.
12. Finnegan L, Wilkie DJ, Wilbur J, Campbell RT, Zong S, Katula S. Correlates of physical activity in young adult survivors of childhood cancers. Oncology Nursing Forum. 2007;34(5): E60-9.
13. Lee Y-S, Laffrey SC. Predictors of physical activity in older adults with borderline hypertension. Nursing Research. 2006;55(2):110-20.
14. Der Ananian CA, Churan C, Adams MA. Correlates of physical activity among blacks and whites with arthritis. American Journal of Health Behavior. 2015;39(4):562-72.
15. Hutton I, Gamble G, McLean G, Butcher H, Gow P, Dalbeth N. What is associated with being active in arthritis? Analysis from the Obstacles to Action study. Internal Medicine Journal. 2010;40(7):512-20.
16. De Groot IB, Bussmann JB, Stam HJ, Verhaar JAN. Actual everyday physical activity in patients with end-stage hip or knee osteoarthritis compared with healthy controls. Osteoarthritis and Cartilage. 2008;16(4):436-42.
17. Aree-Ue S, Roopsawang I, Belza B. Self-regulation in older Thai women with self-reported knee osteoarthritis: A path analysis. Journal of Women & Aging. 2016;28(3): 247-58.
18. Rosenstiel AK, Keefe FJ. The use of coping strategies in chronic low back pain patients: relationship to patient characteristics and current adjustment. Pain. 1983;17(1): 33-44.
19. Waddell G, Newton M, Henderson I, Somerville D, Main CJ. A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain. 1993;52(2):157-68.
20. Scopaz KA, Piva SR, Wisniewski S, Fitzgerald GK. Relationships of fear, anxiety, and depression with physical function in patients with knee osteoarthritis. Archives of Physical Medicine and Rehabilitation. 2009;90(11): 1866-73.
21. Sinikallio SH, Helminen EE, Valjakka AL, VaisanenRouvali RH, Arokoski JP. Multiple psychological factors are associated with poorer functioning in a sample of community-dwelling knee osteoarthritis patients. Journal of Clinical Rheumatology. 2014;20(5):261-7.
22. Bianco T, Eklund RC. Conceptual considerations for social support research in sport and exercise settings: the case of sport injury. Journal of Sport & Exercise Psychology. 2001(2):85-107.
23. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Associations between psychosocial factors and pain intensity, physical functioning, and psychological functioning in patients with chronic pain: a cross-cultural comparison. The Clinical Journal of Pain. 2014;30(8):713-23.
24. Maher JM, Markey JC, Ebert-May D. The other half of the story: effect size analysis in quantitative research. CBE Life Sciences Education. 2013;12(3):345-51.
25. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis & Rheumatism. 1986;29(8):1039-49.
26. Department of Medical Services, Ministry of Public Health. Handbook of older adults screening and assessment. Bangkok: The War Vertarans Organization Publising; 2014.
27. Bellamy N. WOMAC® Osteoarthritis Index: User Guide XI. Queensland 2014
28. Kuptniratsaikul V, Rattanachaiyanont M. Validation of a modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis. Clin Rheumatol. 2007;26(10):1641-5.
29. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment. 1988;52(1):30-41.
30. Wongpakaran N, Wongpakaran T. A revised Thai MultiDimensional Scale of Perceived Social Support. Spanish Journal of Psychology. 2012;15(3):1503-9.
31. Keefe FJ, Affleck G, France CR, Emery CF, Waters S, Caldwell DS, et al. Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis. Pain. 2004;110(3):571-7.
32. Lukkahatai N. Thai cancer pain experience: relationships among pain beliefs, spiritual beliefs, pain appraisal, pain coping, and pain outcomes. Chapel Hill, University of North Carolina; 2004.
33. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross‐cultural health care research: a clear and user‐friendly guideline. Journal of Evaluation in Clinical Practice. 2011;17(2): 268-74.
34. Foundation of Thai Gerontology Research and Development Institute (TGRI). Situation of the Thai elderly 2013. Prasartkul P, editor. Bangkok: Amarin; 2014.
35. World Health Organization Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet. 2004; 363(9403):157-63.
36. Munro BH. Statistical methods for health care research. 5th ed. Philadelphia: Lippincott Willians & Wilkins; 2005.
37. Community Development Department, Ministry of Interior, Thailand. The Basic Minimum Needs Questionnaire 2012 [September10, 2015]. Available from: www.cdc.go.th.
38. Chmelo EA. Physical activity habits in older adults with knee osteoarthritis. Baltimore: University of Maryland; 2010.
39. Espinel PT, Chau JY, van der Ploeg HP, Merom D. Older adults’ time in sedentary, light and moderate intensity activities and correlates: Application of Australian Time Use Survey. Journal of Science and Medicine in Sport. 2015;18(2): 161-6.
40. Martire LM, Stephens MAP, Mogle J, Schulz R, Brach J, Keefe FJ. Daily spousal influence on physical activity in knee osteoarthritis. Annals of Behavioral Medicine. 2013;45(2):213-23.
41. Cotter KA, Lachman ME. No Strain, No Gain: Psychosocial predictors of physical activity across the adult lifespan. Journal of Physical Activity & Health. 2010;7(5):584-94.
42. Koho P, Orenius T, Kautiainen H, Haanpaa M, Pohjolainen T, Hurri H. Association of fear of movement and leisuretime physical activity among patients with chronic pain. Journal of Rehabilitation Medicine. 2011;43(9):794-9.
43. Dekker J, van Dijk GM, Veenhof C. Risk factors for functional decline in osteoarthritis of the hip or knee. Current Opinion in Rheumatology. 2009;21(5):520-410.1097/BOR. 0b013e32832e6eaa.