Understanding the adoption of arthritis self-management: stages of change profiles among arthritis patients
Open accessAbstract
Clinical observations and recent studies suggest that arthritis patients vary considerably in their involvement in self-management efforts. In the literature on health promotion, there is growing recognition that patients may be at different stages of change with respect to the adoption of self-management strategies. The major goal of the present study was to examine whether cluster analysis could be used to identify homogeneous subgroups of patients having persistent arthritis pain based on their responses to a stages of change questionnaire. Participants in this study (103 patients having rheumatoid arthritis and 74 patients having osteoarthritis) completed a stages-of-change measure specific to adoption of a self-management approach to their arthritis. A cluster analysis identified five distinct subgroups of arthritis patients: (1) precontemplation - 44% of the sample; (2) contemplation - 11% of the sample; (3) preparation - 22% of the sample; (4) unprepared action - 6% of the sample; and (5) prepared maintenance - 17% of the sample. These subgroups are generally consistent with what might be expected based on the transtheoretical model of stages of change by Prochaska and DiClemente (Prochaska JO, DiClemente CC. Towards a comprehensive, transtheoretical model of change: states of change and addictive behaviors. In: Miller WR, Heather N, editors. Applied clinical psychology, 2nd ed. Treating addictive behaviors, New York: Plenum Press, 1998. pp. 3-24.), and may have import…
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Patients in the preparation stage show high levels of psychological and physical disability.
“showed high levels of psychological and physical disability in the preparation stage.”
From Adjustment to Chronic Pain in Back Pain Patients Classified According to the Motivational Stages of Chronic Pain Management (2006) · cites this paper as [16]
The motivational stages of the transtheoretical model have been identified in samples of arthritis patients, fibromyalgic patients, and a heterogeneous sample of chronic pain patients.
“According to the transtheoretical model, these motivational stages were identified in a sample of arthritis patients,16”
From Adjustment to Chronic Pain in Back Pain Patients Classified According to the Motivational Stages of Chronic Pain Management (2006) · cites this paper as [16]
Patients who catastrophize have higher levels of motor pain behaviors.
“and higher levels of motor pain behaviors,48”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [48]
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Psychological aspects of persistent pain: Current state of the science
Keefe, F. J., Rumble, M. E., Scipio, C. D., Giordano, L. A., & Perri, L. M. (2004) · The Journal of Pain · doi:10.1016/j.jpain.2004.02.576 · Cited by 897 · see citing works
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A critical review of the pain readiness to change model
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- Authors
- Keefe, F. J., Lefebvre, J. C., Kerns, R. D., Rosenberg, R., Beaupre, P., Prochaska, J., Prochaska, J. O., & Caldwell, D. S.
- Affiliations
- University of Rhode Island (US)
- Wofford College (US)
- VA Connecticut Healthcare System (US)
- Duke Medical Center (US)
- Corresponding author
- Keefe, Francis J.
- Venue
- Pain
- Published
- 2000-08
- Volume
- 87
- Issue
- 3
- Pages
- 303-313
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W1998217278
- Cited by
- 131
- References
- 3
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 6 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 5 · 2012: 7
- FWCI
- 12.90
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Funders
- Arthritis Foundation
- National Institutes of Health (5r01ar035270-11)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR-42261, AR 35270, R01AR042261)
- Topics
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Keywords
- arthritis self-management, stages of change, transtheoretical model, rheumatoid arthritis, osteoarthritis, patient subgroups, precontemplation, contemplation, preparation, pain coping skills training, treatment tailoring, self-management interventions
- MeSH terms
- Adaptation, Psychological, Aged, Analysis of Variance, Arthritis, Rheumatoid, Female, Humans, Male, Middle Aged, Osteoarthritis, Pain, Self Care, Cluster Analysis, Treatment Outcome, Patient Selection, Pain Management
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