942 - Illness Perceptions and Self-Efficacy in Patients with Knee Osteoarthritis

Knee osteoarthritis (KOA) is a leading cause of disability, with outcomes shaped by patients’ beliefs and self-efficacy. Negative illness perceptions and low self-efficacy are linked to greater pain, poorer function, and reduced adherence to treatment. This study aims to characterize illness perceptions and explore their associations with ethnicity and biopsychosocial factors in individuals with KOA. Understanding patient perspectives may help clinicians customize education and interventions, subsequently promoting more personalized and effective care.

Design:

This cross-sectional study recruited English- or Spanish-speaking adults with KOA from an urban rehabilitation clinic serving predominantly charity care and Medicaid-insured patients. Data included demographics, radiographic KOA grade, medical and treatment history, and validated questionnaires: Illness Perception Questionnaire-Revised (IPQ-R), Arthritis Self-Efficacy Scale (ASES), Knee Osteoarthritis Outcomes Score-12 (KOOS-12), and Brief Pain Inventory (BPI). Analyses used descriptive statistics.

Results:

Forty-six participants completed the study (mean age 60 years; 80% women; 59% English speakers; average BMI 33.4). Prior treatment most commonly consisted of physical therapy among English speakers (86%) and injections among Spanish speakers (91%). Participants overall believed aging and overwork contribute most to KOA. English speakers more often attributed KOA to genetics and diet, whereas Spanish speakers attributed it to injury. Participants reported moderate pain severity (BPI 6.1) and interference (5.6), with moderate self-efficacy (ASES 6.0). Function and QoL were poorer in Spanish speakers (median KOOS-12 25.4) compared with English speakers (34.7). English speakers largely agreed that excess weight contributes to pain, while Spanish speakers showed mixed views. Spanish speakers reported greater emotional impact and perceived burden, but higher personal control of KOA. 

Conclusions:

This study highlights differences between English- and Spanish-speaking participants in illness perceptions, causal attributions, as well as differences in treatment. These findings underscore the importance of addressing personal beliefs as well as mitigating provider biases when designing education and treatment interventions.