Self-regulation strategies in managing multi-morbidities among community-dwelling people aging with arthritis

Complexities in managing arthritis and multiple chronic conditions (MCCs) by an individual can explain the poor outcomes in arthritis self-management, higher healthcare utilizations, and poor quality of life (QoL). Evidence supported the aging theory of self-regulation strategies of Selection, Optimization, and Compensation (SR-SOC), as used by people aging with single and MCCs to adapt to chronic disabling symptoms and live well. Based on this theoretical framework, this research investigated the SR-SOC strategies by community-dwelling people aging with arthritis and MCCs. One hundred and forty individuals over age 50 were recruited from community settings and via social media. Each participant completed the demographic questionnaire, Functional Comorbidity Index (FCI), Brief Health Literacy Screening Tool, Lubben Social Network Scale, Patient-Healthcare Provider Communication Scale, Health Insurance Check-list, PROMIS Adult Self-Reported Health Measures, SOC Questionnaire, Arthritis Self-Efficacy Scale, Healthcare Service Utilization Questionnaire, and a visual analogue QoL scale. Correlations analyzed the relationships among the sample characteristics, SR-SOC strategies, and health outcomes. Guided by the theoretical framework, this research used multivariate hierarchical stepwise regressions to predict SR-SOC Strategies, arthritis self-efficacy, healthcare utilizations, and QoL among people aging with arthritis and co-morbidities. The majority of the sample were female (70%), aged 65 to 85 (66%), with less than Bachelor’s degree education (56%), White (34%) or African American (33%), living with others (64%), with personal annual income less than $25,000 (52%). Osteoarthritis (51%) and rheumatoid arthritis (28%) were the two most common types of arthritis. FCI ranged from 2 to 14 with mean of 3.8. The top four comorbidities were obesity, diabetes, visual impairment, and degenerative disc disease. QoL ranged from 0.5 to 10.0 (Mean = 7.2, SD = 2.2). SR-SOC strategy use was predicted significantly by physical symptoms, healthcare provider communication quality, and age (p < .05). Physical symptoms, SR-SOC strategies, especially optimization, and income adequacy significantly predicted arthritis self-efficacy. SR-SOC was significantly associated with QoL only in bivariate correlations but was not a significant predictor in multivariate regressions. Arthritis self-efficacy, mental, and physical symptoms, significantly predicted QoL. SR-SOC was also not a significant predictor of healthcare utilization, instead FCI significantly (p < .05) predicted healthcare utilization. The findings added evidence on the self-regulation strategies for managing arthritis and MCCs