Investigating racial differences in coping with chronic osteoarthritis pain

Alvin C. Jones, C. Kent Kwoh, P. W. Groeneveld, Maria Mor, Ming Geng, Said A. Ibrahim

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Osteoarthritis is a prevalent disease in older patients of all racial groups, and it is known to cause significant pain and functional disability. Racial differences in how patients cope with the chronic pain of knee or hip osteoarthritis may have implications for utilization of treatment modalities such as joint replacement. Therefore, we examined the relationships between patient race and pain coping strategies (diverting attention, reinterpreting pain, catastrophizing, ignoring sensations, hoping and praying, coping self-statements, and increasing behavior activities) for hip and knee osteoarthritis. This is a cross-sectional survey of 939 veterans 50 to 79 years old with chronic hip or knee osteoarthritis pain recruited from VA primary care clinics in Philadelphia and Pittsburgh. Patients had to have moderate to severe hip or knee osteoarthritis symptoms as measured by the WOMAC index. Standard, validated instruments were used to obtain information on attitudes and use of prayer, pain coping strategies, and arthritis self-efficacy. Analysis included separate multivariable models adjusting for demographic and clinical characteristics. Attitudes on prayer differed, with African Americans being more likely to perceive prayer as helpful (adjusted OR∈=∈3.38, 95% CI 2.35 to 4.86) and to have tried prayer (adjusted OR∈=∈2.28, 95% 1.66 to 3.13) to manage their osteoarthritis pain. Upon evaluating the coping strategies, we found that, compared to whites, African Americans had greater use of the hoping and praying method (β∈=∈0.74, 95% CI 0.50 to 0.99). Race was not associated with arthritis pain self-efficacy, arthritis function self-efficacy, or any other coping strategies. This increased use of the hoping and praying coping strategy by African Americans may play a role in the decreased utilization of total joint arthroplasty among African Americans compared to whites. Further investigation of the role this coping strategy has on the decision making process for total joint arthroplasty should be explored.

Original languageEnglish (US)
Pages (from-to)339-347
Number of pages9
JournalJournal of cross-cultural gerontology
Issue number4
StatePublished - Dec 2008


  • Coping strategies
  • Health disparities
  • Joint arthroplasty
  • Osteoarthritis
  • Prayer

ASJC Scopus subject areas

  • Health(social science)
  • Geriatrics and Gerontology


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