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Title: The nature and role of patient expectations in exercise in osteoarthritis
Author: Mitchell, Helen Louise
ISNI:       0000 0004 2669 2308
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2007
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This thesis consisted of five interlinking studies to examine the role of expectations in exercise behaviour in individuals with knee osteoarthritis (OA). In a systematic review on the role of expectations in interventions for chronic musculoskeletal joint pain, positive expectations were consistently related to positive outcomes. However, only three studies were suitable and a number of methodological problems with measuring expectations were identified. A cross-sectional qualitative study explored outcome and treatment expectations and findings were used to develop a questionnaire to measure OA-related beliefs. In a second qualitative study a small number of participants were re-interviewed a year later to examine how the condition and perceptions of the conditions had changed. Findings suggest expectations are malleable and respond to new information. The Knee Pain Beliefs Questionnaire (KPBQ) was developed from the qualitative data and consisted of four factors, including two on expectations (future state/illness expectations and defensive optimism). The measure showed satisfactory internal reliability, test re-retest reliability and discriminant validity. The KPBQ was used to measure expectations in a subsample of primary care OA patients participating in a randomised controlled trial of a self-management intervention. Participants were randomised to one of three arms; control (n=30), individual intervention (n=27), group intervention (n=33). Questionnaire were completed at baseline, post-intervention (approximately 6-8 weeks after baseline) and follow-up (approximately 6 months after post-intervention). In the cross-sectional analyses of these data (N=80), illness expectations and defensive optimism were more strongly related to activity levels than outcome or self-efficacy expectations. In the longitudinal analyses (N=57, 19 per arm), current beliefs increased in both intervention arms and defensive optimism increased in the group arm.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available