Managing arthritis flares: Problem solving and positive psychological factors related to exercise adherence


Problem-solving (PS) is frequently examined relative to psychological dysfunction, while research about positive psychological outcomes is limited.  The Model of Social PS (MSPS) suggests that PS effectiveness is related to outcomes in the face of a problem.  Individuals with arthritis can experience arthritis flares, a spike in symptoms, a problem when trying to exercise regularly.  Guided by MSPS, social cognitive theory, and past exercise research in arthritis, we examined differences between individuals with higher and lower positive problem orientation (PPO) on positive psychological factors related to exercise adherence.  We hypothesized that relative to their exercise, the higher PPO group would report greater (1) self-regulatory efficacy for adaptive strategies (SRE), (2) anticipated persistence, (3) pain acceptance (P-ACC), and (4) psychological well-being (autonomy) than lower PPO counterparts.  We recruited 93 exercising adults (84% female; Mage = 49 years) with medically-diagnosed arthritis who had recently experienced a flare.  Participants completed online measures of SRE, persistence, P-ACC, and autonomy.  A between-group difference on PPO was confirmed (p < .001).  MANOVA revealed a between-groups effect, Wilk’s lambda = .81, p = .001, eta^2 = .20, observed power = .97.  Univariate ANOVAs revealed significant differences on SRE and autonomy (p < .05), where the higher PPO group reported more SRE to perform adaptive actions to regulate activity when faced with arthritis flares (Means: high PPO = 68.7 ± 24.9, low PPO = 58.3 ± 23.9) and greater autonomy for exercise decision-making (Means: high PPO = 33.8 ± 6.3, low PPO = 27.0 ± 8.1).  Findings support MSPS-based hypotheses about greater strength of psychological factors for individuals with more effective PS.  The link between PS and positive psychological factors will be discussed relative to exercise adherence and flare experiences.  This study begins to fill an identified gap in the PS and exercise literature in arthritis. 

Acknowledgments: CIHR and Saskatchewan Health Research Foundation