Schroeder Arthritis Institute, University Health Network, Toronto, Canada.
Arthritis Community Research and Epidemiology Unit, Toronto, Canada.
PLoS One. 2024 Mar 27;19(3):e0299894. doi: 10.1371/journal.pone.0299894. eCollection 2024.
In osteoarthritis (OA) research, disability is largely studied within the context of activities of daily living. Broader consequences for social participation are often overlooked. In prior work, instrumental supports received and their perceived availability were shown to play a role in the maintenance of social participation. Two indicators of social participation were identified, diversity and intensity. The current study extends the findings from this prior cross-sectional work by examining these relationships longitudinally.
Data are from the baseline and 3-year follow-up questionnaires of the Canadian Longitudinal Study on Aging, a population-based study of people ages 45-85 years at baseline. The sample was restricted to those who at baseline reported a doctor diagnosis of OA (n = 4104). Using structural equation modeling, latent variables were derived at each time point for activity limitations, instrumental supports perceived and received, and social participation diversity and intensity. Longitudinal factorial invariance was assessed. Model covariates included age, sex, education, income, marital status, smoking status, obesity, and number of chronic conditions.
For all latent variables, strong factorial longitudinal invariance was found. Activity limitations increased over time. Greater baseline social participation intensity was associated with increases in later intensity and diversity. Increasing activity limitations were associated with decreases in social participation and with increasing receipt of instrumental supports; they were not associated with changes in perceived availability of supports. However, increasing perceived availability was positively associated with social participation intensity.
With a goal of increasing social participation, findings suggest a focus on interventions to reduce activity limitations in OA is necessary. Findings additionally highlight an important role for perceived availability of instrumental supports in maintaining or improving social participation in OA, in addition to current social participation, particularly intensity, for future social participation status.
在骨关节炎（OA）研究中，残疾在很大程度上是在日常生活活动的背景下进行研究的。社会参与的更广泛后果往往被忽视。在之前的工作中，所获得的工具支持及其感知可用性被证明在维持社会参与方面发挥了作用。确定了社会参与的两个指标，多样性和强度。本研究通过纵向研究扩展了先前横断面研究的发现。
数据来自加拿大老龄化纵向研究的基线和 3 年随访问卷，这是一项针对基线时年龄在 45-85 岁的人群的基于人群的研究。该样本仅限于基线时报告有医生诊断为 OA 的人（n=4104）。使用结构方程模型，在每个时间点为活动受限、感知和获得的工具支持以及社会参与多样性和强度推导潜在变量。评估了纵向因子不变性。模型协变量包括年龄、性别、教育、收入、婚姻状况、吸烟状况、肥胖和慢性疾病数量。
对于所有潜在变量，均发现具有很强的因子纵向不变性。活动受限随时间增加。较高的基线社会参与强度与以后的强度和多样性增加相关。活动受限的增加与社会参与的减少以及工具支持的获得增加相关；它们与支持感知可用性的变化无关。然而，感知到的可用性的增加与社会参与强度呈正相关。
为了增加社会参与，研究结果表明，在 OA 中，减少活动受限的干预措施是必要的。研究结果还强调，除了当前的社会参与，尤其是强度，对于未来的社会参与状况，工具支持的感知可用性在维持或改善 OA 中的社会参与方面发挥着重要作用。
