Take Home Messages:

Psychosocial approaches that foster a sense of self reliance and a belief in the patient’s ability to cope with arthritis enhance medical care.

Educational programs, coping skills training and cognitive behavioural therapy can help people gain more control over their diagnosis.

Why the study matters:  

People with arthritis have to cope with pain, stiffness, fatigue and physical limitations. This can have an impact on various aspects of their lives. They may find themselves struggling with work, family and leisure activities.

Quality of life, ability to work and return to work outcomes are all effected by how a patient copes with the symptoms of arthritis. This study reviews the evidence about psychosocial approaches to managing arthritis.

Psychosocial factors refer to two areas:

• The psychological – ie. cognitive and affective; and
• The social – ie. interacting with others and engaging in life activities.  

What the study involved:

This article reviewed 25 research papers that examined the effect of psychosocial approaches in managing arthritis.

Psychosocial approaches include educational programs, coping skills training and cognitive behavioral therapy.  The focus of such approaches is the provision of information necessary to understand the rational for the medical approach selected, and to reassure the patient that they can cope with the condition.  

The approach aims to assist the person to develop skills to deal with their situation and decrease their sense of helplessness.  This may be done through assistance with problem solving, learning ways to modify their activities, work around the issue by using aids, or to shift their attitude or approach to the condition.  

Effects were measured by asking patient to rate;

• Pain;
• Disability;
• Tenderness of joints;
• Psychological status;
• Coping; and
• Self efficiency.

Summary of study findings:

The study found that psychosocial approaches:

• Increase the person’s ability to cope and belief that they are able to manage the condition;
• Reduce psychological distress; and
• Reduce pain and disability, although the effect on this was modest and only short-term.

Features that were found to be associated with poorer outcomes were:

• Passive coping;
• Feelings of helplessness; and
• Catastrophising.

Factors that decreased pain were:

• Active coping; and
• Self efficiency.

It was found that cognitive behavioral therapy must be specifically applied to targeted symptoms and behaviors in order to have a measurable effect.

Original research:

Arthritis and pain. Psychosocial aspects in the management of arthritis pain.
Backman CL
Arthritis Research & Therapy 2006;8:221.

Link to PubMed abstract