van Dongen Britt, Ronteltap Amber, Cijs Bastiaan, Kloek Corelien, Bolman Catherine, Crutzen Rik
Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.
Research Group Innovation of Movement Care, Research Center Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands.
BMC Rheumatol. 2025 May 9;9(1):51. doi: 10.1186/s41927-025-00506-x.
Osteoarthritis (OA) is a chronic disease primarily affecting older adults, mainly impacting the hip and knee joints. The increasing prevalence of OA contributes to rising healthcare demands and costs. Current OA treatment guidelines emphasize the importance of self-management education and guidance, particularly in promoting physical activity and weight management. In addition, improving sleep is crucial for managing OA. Developing effective self-management interventions necessitates a comprehensive understanding of the factors that facilitate these behaviors. Especially for changing health behaviors, it is important to focus on psychosocial factors. Therefore, this systematic review aimed to identify the psychosocial factors associated with physical activity, weight management, and sleep in adults with hip and/or knee OA.
Five databases (PubMed, Embase, CINAHL, PyschINFO, Web of Science) were searched for observational studies reporting statistics on the association between psychosocial determinants and physical activity, weight management, or sleep in people with OA. The methodological quality was assessed using the Quality Assessment Tool for Observational Studies of the National Heart, Lung, and Blood Institute. After screening 5,812 articles, 31 studies were included for analysis.
The results showed that intention, self-efficacy, and willpower beliefs were positively associated with physical activity. Kinesiophobia, pain catastrophizing and pain-related fear were negatively associated with physical activity. Depressive symptoms, negative affect, pain catastrophizing, and low willpower beliefs were associated with poor weight management. Anxiety, depression, pain anxiety, and post-traumatic stress disorder were related to poor sleep behavior.
This review enhances the understanding of the psychosocial factors underlying physical activity, weight management and sleep in OA. These insights are valuable for developing tailored behavior change interventions aimed at improving physical activity, weight management and sleep in patients with hip and/or knee OA. Future research is warranted to gain more in-depth insights, particularly through longitudinal studies and further research into the psychosocial determinants of sleep, as current literature in this area is limited.
骨关节炎（OA）是一种主要影响老年人的慢性疾病，主要累及髋关节和膝关节。OA患病率的不断上升导致医疗保健需求和成本增加。当前的OA治疗指南强调自我管理教育和指导的重要性，特别是在促进身体活动和体重管理方面。此外，改善睡眠对于OA的管理至关重要。制定有效的自我管理干预措施需要全面了解促进这些行为的因素。特别是对于改变健康行为，关注心理社会因素很重要。因此，本系统评价旨在确定与髋和/或膝OA成人的身体活动、体重管理和睡眠相关的心理社会因素。
检索了五个数据库（PubMed、Embase、CINAHL、PyschINFO、Web of Science），以查找报告心理社会决定因素与OA患者身体活动、体重管理或睡眠之间关联统计数据的观察性研究。使用美国国立心肺血液研究所观察性研究质量评估工具评估方法学质量。在筛选了5812篇文章后，纳入31项研究进行分析。
结果表明，意向、自我效能感和意志力信念与身体活动呈正相关。运动恐惧、疼痛灾难化和疼痛相关恐惧与身体活动呈负相关。抑郁症状、消极情绪、疼痛灾难化和低意志力信念与体重管理不善有关。焦虑、抑郁、疼痛焦虑和创伤后应激障碍与睡眠行为不佳有关。
本综述增强了对OA患者身体活动、体重管理和睡眠背后心理社会因素的理解。这些见解对于制定旨在改善髋和/或膝OA患者身体活动、体重管理和睡眠的量身定制行为改变干预措施具有重要价值。未来有必要开展更多研究以获得更深入的见解，特别是通过纵向研究以及对睡眠心理社会决定因素的进一步研究，因为该领域目前的文献有限。
