The role of resilience in quality of life in older adults with osteoarthritis

Abstract

Resilience is the ability to adjust to challenges and successfully sustain this adaptability to adversity. People with resilience have a greater and quicker capacity to recover from difficulties or toughness but it does not mean that the individual is resistant to or devoid of psychopathology. Although resilience is important in old age, the effect of resilience is still not yet being determined among knee osteoarthritis (OA) patients in senior citizens. A non-pharmaceutical cognitive and behavioural technique, pain coping skills training (PCST), is known to manage pain and improve the sense of control in osteoarthritic patients but the outcome is uncertain. The objective of this study was to assess how Pain Coping Strategy Training (PCST) influences resilience and quality of life. It also aimed to explore the relationship between resilience and quality of life (QoL) in older adults with knee osteoarthritis (OA) and investigate the mediating influence of psychological distress in the associations between resilience and QoL. Osteoarthritis was defined using self-reported physician- diagnosed osteoarthritis and the symptom severity was measured using the Knee Injury and Osteoarthritis Outcome Score (KOOS) while Connor Davidson Resilience Scale 10 (CD-RISC 10) used to measure resilience levels. Other scales were used such as the Depression, Anxiety, and Stress Scale-21 (DASS-21) for psychological distress, Control, Autonomy, Self-realization, and Pleasure (CASP-12) for quality of life, and others. PCST may be the most effective intervention for any randomized control trial (RCT) since it may treat both the physical and emotional components however, there is no study relating PCST to resilience. The results of a study of 338 older adults mean age of 66-year-old (SD=5.60) were recruited from December 2021 until January 2023. Of these, 172 participants (50.90%) were diagnosed with knee osteoarthritis and 166 participants (49.10%) had no knee osteoarthritis. There was no significant difference in resilience levels (p=0.492) and QoL (p=0.180) in osteoarthritis and non-osteoarthritis older adults. However, there was a positive correlation between resilience level and QoL. Regression analysis was used to investigate the hypothesis that psychological status (Depression, Anxiety, and Stress) mediated the effect on QoL. Results indicated that Depression was a significant predictor of QoL, B -0.9433, SE = 0.0404, 95%CI [0.0589, 0.2186], β = 0.2546, p<0.001, Anxiety was a significant predictor of QoL, B =-0.8785, SE =0.0441, 95% CI [0.1050, 0.2797], β=0.1968, p=0.0441, and that Stress was a significant predictor of QoL, B=-0.4910, SE=0.0293, 95%CI [0.0060, 0.1194], β =0.3625, p<0.001. These results supported the mediation hypothesis. In other words, stress, anxiety, and depression play mediating roles in the relationship between resilience and quality of life.