Associations of Coping Strategies with Diary Based Pain Variables Among Caucasian and African American Patients with Osteoarthritis

The purposes of this study are to examine the associations between pain coping strategies and daily diary-based pain measures and to determine whether these associations differed by race (African American and Caucasian). Primary care patients from the Durham Veterans Affairs and Duke University Medical Centers (N = 153) with hand, hip, or knee osteoarthritis (OA) completed electronic pain diaries on a one-weekend day and one weekday. The maximum, range (maximum minus minimum pain), and area under the curve (AUC) of joint pain ratings were calculated. Pain coping (Coping Strategies Questionnaire (CSQ) coping attempts, catastrophizing, and praying/hoping subscale scores) was assessed prior to diary entries and at the end of each diary day (total, problem-focused, and emotion-focused scores from Stone and Neale's Daily Coping Inventory). Pearson correlations between pain variables and coping measures were examined. Linear mixed models were fit including age, race, weekend/weekday, study enrollment site, education level, pain medication use, self-rated health, Arthritis Impact Measurement Scales affect and function subscales, and interactions of coping measures with race and weekend day/weekday status. Correlations between coping and pain measures were 0.12-0.45. In adjusted models, maximum pain and pain range were associated with all three diary-based coping measures; maximum pain was associated with CSQ coping attempts; and AUC was associated with CSQ praying/hoping. Interactions were not significant. Among participants with OA, pain coping strategies were related to important aspects of the pain experience, particularly pain range and maximum pain. However, race did not modify associations of pain coping strategy use and the pain experience.