Arthritic elders' psychological well-being as influenced by pain, functional impairment, self-efficacy, and social support

An important nursing role is to assist older adults with arthritis to manage arthritis pain and disability and maintain psychological well-being. The purpose of this study was to test a proposed theoretical model, based on Lazarus's theory of stress and coping, which explained the psychological well-being (PWB) of older adults with arthritis as influenced by arthritis pain, functional impairment, satisfaction with comfort, satisfaction with functional ability, pain self-efficacy, general self-efficacy, and social support. A descriptive, correlational design was used. The sample consisted of 202 community residing veterans who were age 60 years and older, had self-reported arthritis, and attended the outpatient clinic of a large Veterans Affairs medical center. Data were collected through interviewer administered self-report questionnaires which addressed pain, functional impairment, satisfaction with comfort, satisfaction with functional ability, pain self-efficacy, general self-efficacy, social support, PWB, general health characteristics, and arthritis characteristics. The questionnaires were completed by interviewers at the clinic or by telephone. Path analysis procedures were used to test the proposed model. The causal model was empirically supported, with the exception of four hypothesized paths which were not statistically significant. Satisfaction with functional ability, pain self-efficacy, general self-efficacy, and social support explained 51% of the variance in PWB. Pain indirectly affected PWB via functional impairment. Functional impairment indirectly affected PWB via satisfaction with functional ability. Satisfaction with comfort did not predict PWB. Satisfaction with functional ability, pain self-efficacy, general self-efficacy, and social support were important influences in maintaining the psychological well-being of older adults with arthritis. The finding that functional impairment was a greater determinant of psychological adjustment to arthritis than was pain indicates that older adults' functional ability is an important area for nursing practice and future research.