Patient Education and Exercise-Based Self-Management in Knee Osteoarthritis: Effects on Pain, Function, and Quality of Life

Abstract

Background: Knee OA is a chronic musculoskeletal disorder, which frequently results in pain, functional impairment, a lower overall level of physical activity and poorer health-related quality of life.Patient education and exercise self-management is a crucial part of current care of knee osteoarthritis (OA), but how enabling this type of care is for patients' self-efficacy in explaining its contribution to patients' quality of life has not been examined.

Objective: We aimed to explore health-related quality of life outcomes after the implementation of patient education and exercise-based self-management and to examine whether or not self-efficacy mediated the effects on the health-related quality of life after patient education and exercise-based self-management for knee OA.

Methods: Quantitative cross sectional design was used. Participants will be focused on knee OA patients attending Mother Theresa University Hospital Center, University hospital of Trauma and Pegasus Med Clinic who will be diagnosed with knee OA on structured questionnaires, a total of 450 patients. Partial Least Squares Structural Equation Modeling (PLS-SEM) was then used to evaluate the measurement and structural models.

Findings: Results showed that patient education had a significant effect on increasing the health-related quality of life and also had a positive effect in raising the patient’s self-efficacy. Exercise based self-management also had a strong effect on aspects of health-related quality of life and self-efficacy and was the best predictor of self-efficacy. In addition, higher levels of self-efficacy made a significant contribution to higher quality of health. The mediation analysis revealed that both patient education and the exercise self-management significantly but weakly mediated the relationship between self-efficacy and QOL while self-efficacy partially mediated the connection between exercise based self-management and QOL. These findings corroborate recent evidence highlighting the significance of education, exercise, self-management and self-efficacy in osteoarthritis interventions.

Conclusion: The conclusion of the study was that a patient centered approach combining structured patient education, sustainable exercise based management strategies, and self-efficacy supporting strategies, may be beneficial for improving patients' quality of life living with knee OA.