Pilot study of pain and coping among patients with osteoarthritis: a daily diary analysis.

BACKGROUND AND OBJECTIVES: Few studies have examined patterns of pain and coping among patients with osteoarthritis (OA). This pilot study used a daily diary approach to examine pain and coping strategy use among white and nonwhite veterans with OA. METHODS: Participants (23 white, 13 nonwhite; 89% male; mean age = 63 years) completed diaries of pain (10-cm visual analog scale) and coping (total, problem-focused, and emotion-focused) for 30 days. Analyses examined relationships of mean self-reported pain severity and variability with coping strategy use as well as racial differences in these associations. RESULTS: The mean pain level (4.46 [scale of 0-10], standard deviation [SD] = 2.12) and mean within-subject pain variance (1.94, SD = 1.79) were similar between white and nonwhite participants. With respect to pain variability, 2 distinct subgroups were observed, with approximately half of participants reporting high variability and half reporting low variability. The mean total coping score (on a scale of 0-7) was 2.62 (SD = 1.77), with problem-focused strategies being used more often than emotion-focused. There were no significant associations between coping (total, problem-focused, and emotion-focused) and mean pain severity, but the direction of these relationships differed according to race. CONCLUSION: Results of this pilot study showed considerable between-subject variability in pain and coping strategy use as well as some racial differences. Medical treatment and self-management approaches may be improved if they can be tailored according to patients' pain patterns and preferred coping strategies.

Duke Scholars

Author Kelli Dominick Allen Medicine, General Internal Medicine

Author Maren Karine Olsen Biostatistics & Bioinformatics, Division of Biostatistics