4117.0: Tuesday, October 23, 2001 - Board 4

Abstract #29520

Examining the mediating effect of coping-efficacy between activity limitation and loss of independence in people with arthritis

Peizhong Peter Wang, MD, Monique A. Gignac, PhD, Cheryl A. Cott, PhD, and Elizabeth M. Badley, PhD. Arthritis Community Research & Evaluation Centre (ACREU), University Health Network, University of Toronto, 610 University Avenue, Suite 16-704, Toronto, ON M5G 2M9, Canada, 416-946-4501 Ext. 4739, wang@uhnres.utoronto.ca

Objective: Being physically independent is important to participation of people with chronic conditions. This study examines whether the relationships between activity limitations and independence are mediated by perceptions of coping successfully with the health condition (i.e., coping efficacy).

Method: Data come from a cross-sectional survey of 286 adults, aged 55 or older, with osteoarthritis and/or osteoporosis. Physical independence was assessed by asking to what extent respondents' OA/OP had affected their independence on a 5-level scale from "not at all" to "a great deal". Activity limitation was examined in 3 domains: personal care, community mobility, and household activity. A coping efficacy scale was derived from three items scored on a 5-point Likert-type scale from strongly disagree to strongly agree. Structural equation modeling was used to test our model.

Results: Activity limitations in personal care and household activities were directly associated with perceptions of independence, with statistically significant standardized path coefficients of 0.41 and 0.32 respectively. The effect of community mobility on independence was mediated through coping efficacy with significant standardized path coefficients of -0.85 (community mobility to coping efficacy) and -0.14 (coping efficacy to independence). The overall model's goodness of fit was excellent (R2=0.59, ch-square/df=1.4, CFI=0.97, and NNFI=0.97).

Conclusion: The relationship between activity limitation and independence differs by domain and is differentially mediated by personal contextual factors, such as coping efficacy.

Learning Objectives: 1. Understand the advantages of using latent constructs to measure disability 2. Understand the effects of activity limitation on participation can be mediated by contextual variables.

Keywords: Disability Studies, Statistics

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA