Self-efficacy and health status in rheumatoid arthritis: a two-year longitudinal observational study

Objective. To investigate the relationship between baseline level of self-efficacy for pain and other symptoms and changes in measures for similar dimensions of health status over a period of 2 yr in patients with rheumatoid arthritis (RA). Methods. Data collected from patients with RA enrolled in a county-based disease register in Oslo. Norway were analysed: 815 patients were examined by mail questionnaire in 1994 and again in 1996. Relationships of the baseline level of self-efficacy and demographic variables with 2-yr changes in health status measures were examined by bivariate and multiple regression analysis. The following health status measures were included: pain and fatigue on a visual analogue scale; the patients global assessment of disease activity; the symptom and affect scales of the Arthritis Impact Measurement Scales (AIMS2): and the bodily pain, mental health, general health and vitality scales of the Short Form-36 (SF-36). Results. For all health status measures, there was a significant correlation between the change over a 2-yr span and baseline self-efficacy, even after adjustment for demographic variables and for the baseline level of the health status measure. Favourable changes M;ere associated with high self-efficacy scores. Conclusions. In patients with RA, the baseline levels of self-efficacy for pain acid other symptoms seem to influence 2-yr changes in health status measures regarding these aspects.