Title
Is avoidant coping independent of disease status and stable over time in patients with ankylosing spondylitis?
Author
TNO Preventie en Gezondheid
Boonen, A.
van der Heijde, D.
Landewé, R.
Chorus, A.
van Lankveld, W.
Miedema, H.
van der Tempel, H.
van der Linden, S.
Publication year
2004
Abstract
Objective: To determine whether avoidant coping in ankylosing spondylitis (AS) is independent of disease status and whether it is stable over time. Methods: 658 patients with AS completed a postal questionnaire on health status, including pain and stiffness (BASDAI), physical function (BASFI), and coping (CORS). In CORS, "decreasing activities to cope with pain" and "pacing to cope with limitations" reflect avoidant behavioural coping. Ninety patients continued in a longitudinal study and 70 completed the CORS after four years. The adjusted contribution of age, sex, disease duration, educational level, pain (BASDAI), and physical function (BASFI) to the two avoidant coping strategies at first assessment was determined by multiple linear regression. Agreement between coping at first assessment and four years later was determined by intraclass correlation, and the correlation between change in coping and change in disease status over time by Pearson's correlation. Results: At first assessment, worse physical function (BASFI) and more pain (BASDAI) were associated with "decreasing activities to cope with pain". Worse physical function, but not pain, was associated with "pacing to cope with limitations". The contribution of physical function or pain to the total explained variance in each of the coping strategies was small. Disease duration was not a determinant of avoidant coping, but greater age was associated with "pacing to cope with limitations". Change in avoidant coping strategies over time could not be explained by change in function or pain. Conclusions: In AS, avoidant coping at a particular time is largely independent of disease duration or status. Variability in avoidant coping over a limited period of four years cannot be explained by change in disease status.
Subject
age
ankylosing spondylitis
avoidance behavior
coping behavior
correlation analysis
disease activity
disease association
disease duration
education
gender
health status
immobilization
major clinical study
medical assessment
multivariate logistic regression analysis
physical activity
physical capacity
rigidity
time
Adaptation, Psychological
Adolescent
Adult
Cross-Sectional Studies
Female
Health Status Indicators
Humans
Longitudinal Studies
Male
Middle Aged
Pain
Pain Measurement
Questionnaires
Severity of Illness Index
Spondylitis, Ankylosing
To reference this document use:
http://resolver.tudelft.nl/uuid:e392071b-c83b-4832-9df8-c77b61aadc87
DOI
https://doi.org/10.1136/ard.2003.012435
TNO identifier
238036
ISSN
0003-4967
Source
Annals of the Rheumatic Diseases, 63 (63), 1264-1268
Document type
article