Abstract
We examined the personal models of osteoarthritis (OA) of 61 patients over 60 years of age. Models were elicited using a structured interview. Shared beliefs included perceiving OA as a serious, painful, chronic, and incurable condition that can be managed by recommended medical treatment. Considerable individual differences were found on six personal-model constructs: Symptoms, Seriousness, Cause, Control, Helpfulness of Treatment, and Negative Feelings about Treatment. The constructs of Symptoms and Seriousness were consistently related to a variety of important outcomes. For example, participants with higher scores on Symptoms and Seriousness reported higher levels of self-management (both concurrently and prospectively), reported more utilization of medical services, and experienced a poorer quality of life. The implications for the design of health-education materials and for patient-provider interactions are discussed.
Similar content being viewed by others
References
Anderson, L. A., DeVellis, R. F., Boyles, B., and Feussner, J. R. (1989). Patients' perceptions of their clinical interventions: Development of the multidimensional desire for control scales.Health Educ. Res. 4: 383–397.
Altman, R. D. (1987). Overview of osteoarthritis.Am. J. Med. 83: 65–69.
Belgrave, L. L. (1990). The relevance of chronic illness in the everyday lives of elderly women.J. Aging Health 2: 475–500.
Bishop, G. D. (1991). Understanding the understanding of illness: Lay disease representations. In Skelton, J. A., and Croyle, R. T. (eds.),Mental Representation in Health and Illness, Springer-Verlag, New York, pp. 32–59.
Blumhagen, D. (1982). The meaning of hyper-tension. In Chrisman, N. J., and Maretzki, T. W. (eds.),Clinically Applied Anthropology, D. Reidel, New York, pp. 297–323.
Clark, N. M., Becker, M. N., Janz, N. K., Lorig, K., Rakowski, W., and Anderson, L. (1991). Self-management of chronic disease by older adults.J. Aging Health 3: 3–27.
Dekker, J., Boot, B., van der Woude, L. H. V., and Bijlsma, J. W. J. (1992). Pain and disability in osteoarthritis: A review of biobehavioral mechanisms.J. Behav. Med. 15: 189–214.
Glasgow, R. E., Toobert, D. J., and Hampson, S. E. (1991). Participation in outpatient education programs: How many patients take part and how representative are they?Diabetes Educ. 5: 376–380.
Hampson, S. E., Glasgow, R. E., and Toobert, D. J. (1990). Personal models of diabetes and their relations to self-care activities.Health Psychol. 9: 632–646.
Hampson, S. E., Glasgow, R. E., Zeiss, A. M., Birskovich, S. F., Foster, L., and Lines, A. (1993). Self-management of osteoarthritis.Arth. Care Res. 6: 17–22.
Helman, C. G. (1978). “Feed a cold, starve a fever”—Folk models of infection in an English suburban community, and their relation to medical treatment.Cult. Med. Psychiatr. 2: 107–137.
Keller, M. L., Leventhal, H., Prohaska, T. R., and Leventhal, E. A. (1989). Beliefs about aging in a community sample.Res. Nurs. Health 12: 247–255.
Kleinman, A. (1986).Social Origins of Distress and Disease: Depression, Neurasthenia, and Pain in Modern China, Yale University Press, New Haven, CT.
Kleinman, A., Eisenberg, L., and Good, B. (1978). Culture, illness and care: Clinical lessons from anthropologic and cross-cultural research.Ann. Intern. Med. 88: 251–258.
Lau, R. R., and Hartman, K. A. (1983). Common sense representations of common illness.Health Psychol. 2: 167–185.
Lau, R. R., Bernard, T. M., and Hartman, K. A. (1989). Further explorations of common-sense representations of common illnesses.Health Psychol. 8: 195–219.
Leventhal, H., and Diefenbach, M. (1991). The active side of illness cognition. In Skelton, J. A., and Croyle, R. T. (eds.),Mental Representation in Health and Illness, Springer-Verlag, New York, pp. 246–272.
Leventhal, H., and Nerenz, D. (1985). The assessment of illness cognition. In Karoly, P. (ed.).Measurement Strategies in Health, Wiley & Sons, New York, pp 517–554.
Lorig, K. R., and Fries, J. F. (1986).The Arthritis Helpbook: A Tested Self-Management Program for Coping with Your Arthritis, Addison-Wesley, Reading, MA.
Lorig, K. R., Cox, T., Cuevas, Y., Kraines, R. G., and Britton, M. C. (1984). Converging and diverging beliefs about arthritis: Caucasian patients, Spanish speaking patients, and physicians.J. Rheumatol. 11: 76–79.
Lorig, K., Chastain, R. L., Ung, E., Shoor, S., and Holman, H. R. (1989). Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis.Arth. Rheum. 32: 37–44.
Mattis, S. (1988).Dementia Rating Scale Profession Manual, Psychological Assessment Resources, Odessa, FL.
Meyer, D., Leventhal, H., and Gutmann, M. (1985). Common-sense models of illness: The example of hypertension.Health Psychol. 4: 115–135.
Montgomery, K. M., and Costa, L. (1983). Neuropsychological test performance of a normal elderly sample. Paper presented at the International Neuropsychological Society Meeting, Mexico City.
Panush, R. S. (1989). Exercise and arthritis.Topics Geriat. Rehab. 4: 23–31.
Prohaska, T. R., Leventhal, E. A., Leventhal, H., and Keller, M. L. (1985). Health practices and illness cognition in young, middle aged, and elderly adults.J. Gerontol. 40: 569–578.
Rakowski, W. (1988). Age cohorts and personal health behavior in adulthood.Res. Aging 10: 3–35.
Rakowski, W., Julius, M., Hickey, T., and Halter, J. B. (1987). Correlates of preventive health behavior in late life.Res. Aging 9: 331–355.
Skelton, J. A., and Croyle, R. T. (1991).Mental Representation in Health and Illness, Springer-Verlag, New York.
Stewart, A. L., Hays, R. D., and Ware, J. E., Jr. (1988). Communication: The MOS Short-Form General Health Survey: Reliability and validity in a patient population.Med. Care 26: 724–735.
Stewart, A. L., Greenfield, S., Hays, R. D., Wells, K., Rogers, W. H., Berry, S.D., McGlynn, E. A., and Ware, J. E. (1989). Functional status and well-being of patients with chronic conditions: Results from the Medical Outcomes Study.JAMA 202: 907–913.
Summers, M. N., Haley, W. E., Reveille, J. D., and Alarcon, G. S. (1988). Radiographic assessments and psychologic variables as predictors of pain and functional impairment in osteoarthritis of the knee or hip.Arth. Rheum. 31: 204–209.
Turk, D. C., Rudy, T. E., and Salovey, P. (1986). Implicit models of illness.J. Behav. Med. 9: 453–474.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hampson, S.E., Glasgow, R.E. & Zeiss, A.M. Personal models of osteoarthritis and their relation to self-management activities and quality of life. J Behav Med 17, 143–158 (1994). https://doi.org/10.1007/BF01858102
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01858102