Ellen M H Selten1, Rinie Geenen2, Henk J Schers3, Frank H J van den Hoogen4,5, Roelien G van der Meulen-Dilling6, Willemijn H van der Laan7, Marc W Nijhof8, Cornelia H M van den Ende4, Johanna E Vriezekolk4. 1. Department of Rheumatology, Sint Maartenskliniek, Hengstdal 3, Ubbergen, 6574 NA, Nijmegen, The Netherlands. e.selten@maartenskliniek.nl. 2. Department of Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, The Netherlands. 3. Department of Primary and Community Care, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. 4. Department of Rheumatology, Sint Maartenskliniek, Hengstdal 3, Ubbergen, 6574 NA, Nijmegen, The Netherlands. 5. Department of Rheumatology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands. 6. Physical Therapy and Manual Therapy Partnership Velperweg, Velperweg 71, 6824 HH, Arnhem, The Netherlands. 7. Department of Rheumatology, Sint Maartenskliniek, Polanerbaan 2, 3447 GN, Woerden, The Netherlands. 8. Department of Orthopedics, Sint Maartenskliniek, Hengstdal 3, Ubbergen, 6574 NA, Nijmegen, The Netherlands.
Abstract
PURPOSE: Patients' beliefs about treatment modalities for knee and hip osteoarthritis (OA) will underlie their treatment choices. Based on the Theory of Planned Behavior, it is hypothesized that patients' beliefs, subjective norm, and perceived behavioral control guide their treatment choices. Also, symptom severity and one's inherent tendency to approach or avoid situations are assumed to play a role. The objective of this study was to test whether these variables were associated with intended treatment choices in knee and hip OA. METHODS: Patients with knee and hip OA were randomly selected from hospital patient records. They completed the Treatment beliefs in OsteoArthritis questionnaire to assess positive and negative treatment beliefs regarding five treatment modalities: physical activities, pain medication, physiotherapy, injections, and arthroplasty. Other measures were intention, subjective norm, perceived behavioral control (ASES), symptom severity (WOMAC), and the person's general tendency to approach or avoid situations (RR/BIS scales). Three models were tested using path analyses to examine the hypothesized associations. RESULTS: Participants were 289 patients. Positive treatment beliefs and subjective norm were consistently associated with intended treatment choice across all treatment modalities. Negative treatment beliefs were associated with intended treatment choices for pain medication and arthroplasty. Other associations were not significant. CONCLUSIONS: This is the first study testing the Theory of Planned Behavior in the context of treatment choices in OA. Findings suggest that foremost positive beliefs about treatment modalities and the norms of one's social environment guide a specific treatment choice. Unexpectedly, symptom severity was not related to intended treatment choices.
PURPOSE:Patients' beliefs about treatment modalities for knee and hip osteoarthritis (OA) will underlie their treatment choices. Based on the Theory of Planned Behavior, it is hypothesized that patients' beliefs, subjective norm, and perceived behavioral control guide their treatment choices. Also, symptom severity and one's inherent tendency to approach or avoid situations are assumed to play a role. The objective of this study was to test whether these variables were associated with intended treatment choices in knee and hip OA. METHODS:Patients with knee and hip OA were randomly selected from hospital patient records. They completed the Treatment beliefs in OsteoArthritis questionnaire to assess positive and negative treatment beliefs regarding five treatment modalities: physical activities, pain medication, physiotherapy, injections, and arthroplasty. Other measures were intention, subjective norm, perceived behavioral control (ASES), symptom severity (WOMAC), and the person's general tendency to approach or avoid situations (RR/BIS scales). Three models were tested using path analyses to examine the hypothesized associations. RESULTS:Participants were 289 patients. Positive treatment beliefs and subjective norm were consistently associated with intended treatment choice across all treatment modalities. Negative treatment beliefs were associated with intended treatment choices for pain medication and arthroplasty. Other associations were not significant. CONCLUSIONS: This is the first study testing the Theory of Planned Behavior in the context of treatment choices in OA. Findings suggest that foremost positive beliefs about treatment modalities and the norms of one's social environment guide a specific treatment choice. Unexpectedly, symptom severity was not related to intended treatment choices.
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