The Effect of a Group Support Enhancing Self-Management Program on Lifestyle Modification Behaviors among Indonesian Older Adults with Knee Osteoarthritis


  • Ploenpit THANIWATTANANON Department of Adult & Gerontological Nursing, Faculty of Nursing, Prince of Songkla University, Songkhla 90110
  • Friska SINAGA Department of Medical Nursing, Saint Borromeo School Health Science, Bandung, West Java


Group support, self-management, older adults, lifestyle modification behaviours, knee osteoarthritis


Osteoarthritis, as a common type of degenerative joint disease, puts older adults at high risk. It could impact the wellbeing of older adults, including physical, psychological, social, and economic factors. The aim of this study was to examine the effect of group support enhancing a self-management program on lifestyle modification behaviors among Indonesian older adults with knee osteoarthritis. Seventy-nine participants who met the inclusion criteria were recruited and assigned into the experimental group and the control group. Lifestyle modification behavior was measured during the first week, and after 6 weeks, of the program by using a Lifestyle Modification Behaviors Questionnaire (LMBQ). The internal consistency reliability coefficient of the LMBQ was 0.84. An independent t-test was conducted to examine the between group effect of the program. There was a statistically significant difference in lifestyle modification behaviors between the experimental group and the control group after receiving the program (t = 18.19, p = < 0.05). The group support enhancing self-management program effectively improved lifestyle modification behaviors among Indonesian older adults with knee osteoarthritis.


Download data is not yet available.


Metrics Loading ...


E Olivotto, M Otero, KB Marcu and MB Goldring. Pathophysiology of osteoarthritis: Canonical NF-κB/IKKβ-dependent and kinase-independent effects of IKKα in cartilage degradation and chondrocyte differentiation. RMD Open 2015; 1, 1-6.

MI Arissa. Prevalence of osteoarthritis cases in RSU Dokter Soedarso Pontianak. Med. J. Tanjungpura Univ. 2013; 1, 1-10.

MR Sonjaya. 2016, The Characteristic of knee Osteoarthritis Patient in OPD of Al-Islam Hospital Bandung, Ph. D. Dissertation. Bandung Islamic Univeristy, Bandung.

J Grime, JC Richardson and BN Ong. Perceptions of joint pain and feeling well in older people who reported being healthy: A qualitative study. Brit. J. Gen. Pract. 2010; 60, 597-603.

PG Conaghan, M Porcheret, SR Kingsbury, A Gammon, A Soni, M Hurley, MP Rayman, J Barlow, RG Hull, J Cumming, K Llewelyn, F Moscogiuri, J Lyons and F Birrell. Impact and therapy of osteoarthritis: The Arthritis Care OA Nation 2012 survey. Clin. Rheumatol. 2015; 34, 1581-8.

JV Milano, MH Barbero, SG Basallote, JV Martín, EV Lladó, HM Serrano, GR Roca, LS Bellmunt, JD Muñoz, JF Rodríguez, AC García, JJ Díaz, ÁR Cossío, RB Prieto and JL Caro. Anxiety and depression in knee osteoarthritic patients: Results from emartro study. Osteoarthritis Cartilage 2016; 24, 218-9.

FJ Keefe, L Porter, T Somers, R Shelby and AV Wren. Psychosocial interventions for managing pain in older adults: Outcomes and clinical implications. Brit. J. Anaesth. 2013; 111, 89-94.

TE McAlindon, RR Bannuru, MC Sullivan, NK Arden, F Berenbaum, SM Bierma-Zeinstra, GA Hawker, Y Henrotin, DJ Hunter, H Kawaguchi, K Kwoh, S Lohmander, F Rannou, EM Roos and M Underwood. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage 2014; 2, 363-88.

M Basedow, H Williams, EM Shanahan, WB Runciman and A Esterman. Australian guideline practice management of osteoarthritis following the release of the RACGP guideline for the non-surgical management of hip and knee osteoarthritis. BMC Res. Note 2015; 8, 536.

CK O'Neil, JT Hanlon and ZA Marcum. Adverse effects of analgesics commonly used by older adults with osteoarthritis: Focus on non-opioid and opioid analgesics. Am. J. Geriatr. Pharmacother. 2012; 10, 331-42.

G Sakalauskienė and D Jauniškienė. Osteoarthritis: Etiology, epidemiology, impact on the individual and society and the main principles of management. Medicina 2010; 46, 790-7.

EULAR recommendations for the non-pharmacological care management of hip and knee osteoarthritis, Available at:, accessed November 2016.

TJ Somers, JA Blumenthal, F Guilak, VB Kraus, DO Schmitt, MA Babyak, LW Craighead, DS Caldwell, JR Rice, DC McKee, RA Shelby, LC Campbell, JJ Pells, EL Sims, R Queen, JW Carson, M Connelly, KE Dixon, LJ Lacaille, JL Huebner, WJ Rejeski and FJ Keefe. Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: A randomized controlled study. Pain 2012; 153, 1199-209.

L Fernandes, KB Hagen, JW Bijlsma, O Andreassen, P Christensen, PG Conaghan, M Doherty, R Geenen, A Hammond, I Kjeken, LS Lohmander, H Lund, CD Mallen, T Nava, S Oliver, K Pavelka, I Pitsillidou, JA da Silva, J de la Torre, G Zanoli and TPV Vlieland. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013; 72, 1125-135.

H Manaf. Barriers to participation in physical activity and exercise among middle-aged and elderly individuals. Singapore Med. J. 2013; 54, 581-6.

FH Kanfer and L Gaelick-Buys. Self-Management Methods, Helping People Change: A Textbook of Methods. Vol 52. Elmsford, New York, 1991, p. 305-60.

AA Richard and K Shea. Delineation of self‐care and associated concepts. J. Nurs. Scholarsh. 2011; 43, 255-64.

Y Huang. 2013, The Effect of Nurse-Led Tailored Self-Management Program on Pain Outcomes among Elders with Knee Osteoarthritis in China. Master Thesis of Faculty of Nursing, Prince of Songkla University, Thailand.

FSD Silva, FE de Melo, MM do Amaral, VV Caldas and IL Pinheiro. Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial. J. Rehabil. Res. Dev. 2015; 52, 309-21.

D Carnes, KE Homer, CL Miles, T Pincus, M Underwood, A Rahman and SJ Taylor. Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: A systematic literature review. Clin. J. Pain 2012; 28, 344-54.

GP Fine. Chronic pain management in older adults: Special considerations. J. Pain Symptom Manag. 2009; 38, 4-14.

N Ng, M Hakimi, P Byass, S Wilopo and S Wall. Health and quality of life among older rural people in Purworejo District, Indonesia. Glob. Health Act. 2010; 3, 78-87.

DF Polit and CT Beck. Nursing Research: Generating and Assessing Evidence for Nursing Practice. 9th eds. Lippincott William and Wilkins, New York, 2012.

M Lequesne. Indices of severity and disease activity for osteoarthritis. Semin. Arthritis. Rheum. 1991; 20, 48-54.

I Lancu and A Olmer. The minimental state examination: An up-to-date review. Harefuah 2006, 145, 687-701.

K Kroenke, RL Spitzer and JB Williams. The patient health questionnaire-2: Validity of a two-item depression screener. Med. Care 2003; 41, 1284-92.

B Stubbs, M Hurley and T Smith. What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis? A systematic review of physical activity correlates. Clinical Rehabil. 2015; 29, 80-94.

M Hartmann, E Bäzner, B Wild, I Eisler and W Herzog. Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis. Psychother. Psychosom. 2010; 79, 136-48.




How to Cite

THANIWATTANANON, P., & SINAGA, F. (2018). The Effect of a Group Support Enhancing Self-Management Program on Lifestyle Modification Behaviors among Indonesian Older Adults with Knee Osteoarthritis. Walailak Journal of Science and Technology (WJST), 16(8), 593-600. Retrieved from