[2026-01-26] Effect of Positive Psychological Capital and Self-Management Model Interventions on Pain and Functional Difficulty in Persons With Osteoarthritis

Abstract

Background: Osteoarthritis is a prevalent global health challenge, particularly among the elderly, and leads to significant physical disability, emotional distress, and socioeconomic burden. Effective interventions addressing these multifaceted effects are limited, especially in patients with severe knee osteoarthritis awaiting a surgical intervention. This study was guided by 2 theoretical frameworks: the positive psychological capital (PsyCap) theory, which focuses on enhancing psychological resilience, motivation, and coping strategies; and the self-management model, which emphasizes goal setting, symptom tracking, and adherence to self-care behaviors.

Objectives: To evaluate the effectiveness of a novel intervention integrating PsyCap theory and self-management model strategies to enhance self-care behavior, alleviate pain, and reduce mobility difficulties among patients with severe knee osteoarthritis (Kellgren-Lawrence grades 3-4).

Methods: A quasi-experimental pretest-posttest design was used between May and July 2023 at the outpatient surgery department of a university hospital. A total of 34 patients with primary knee osteoarthritis were randomly assigned into experimental (n = 17) and control (n = 17) groups. The experimental group received a self-care behavior enhancement program integrating PsyCap and self-management principles. Outcomes were assessed at 3 time points: baseline, postintervention (4 weeks), and follow-up (12 weeks). Statistical analyses included descriptive statistics and 2-way repeated measures analysis of variance (ANOVA) to examine within- and between-group effects over time.

Results: Compared to the control group, the experimental group demonstrated significant improvements in self-care behaviors (F[1,32] = 24.982; P < .001; η² = 0.438), with significant time-group interaction effects (F[1.374,43.960] = 38.581; P < .001; η² = 0.547). Additionally, pain and mobility difficulties significantly decreased in the experimental group (F[1.640,52.473] = 42.261; P < .001; η² = 0.569), whereas no significant changes were observed in the control group.

Conclusions: Integrating PsyCap theory and the self-management model significantly improved self-care behavior and reduced pain and mobility difficulty in patients with severe knee osteoarthritis awaiting surgery. These benefits were sustained over 12 weeks.