The Effect of Group Support Enhancing Self-Management Program on Lifestyle Modification Behaviors Among Indonesian Elders with Knee Osteoarthritis

Friska Sinaga, Ploenpit Thaniwattananon


Osteoarthritis, as the common type of degenerative joint diseases, leads elderly at high risk of having osteoarthritis. It could impact on the wellbeing of elders including physical, psychological, social, and economic factors. The aim of this study was to examine the effect of group support enhancing self-management program on lifestyle modification behaviors among Indonesian elders with knee osteoarthritis. Seventy nine participants who met the inclusion criteria were recruited and assigned into experimental group and control group. A lifestyle modification behavior was measured during the first week and after six weeks of the program by using Lifestyle Modification Behaviors Questionnaire (LMBQ). The internal consistency reliability coefficient of the LMBQ was .84. An independent t-test was conducted to examine the between group effect of the program. There was a statistically significant difference of lifestyle modification behaviors between the experimental group and the control group after receiving the program (t = 18.19, p = <.05). Group support enhancing self-management program effectively improves lifestyle modification behaviors among Indonesian elders with knee osteoarthritis


group support; self-management; elders; lifestyle modification behaviors


Olivotto, E., Otero, M., Marcu, K. B., & Goldring, M. B. (2015). Pathophysiology of osteoarthritis: canonical NF-κB/IKKβ-dependent and kinase-independent effects of IKKα in cartilage degradation and chondrocyte differentiation. RMD Open, 1(s1), 1-6. doi: 10.1136/rmdopen-2015-000061

Arissa, M. I. (2013). Pola distribusi kasus osteoartritis di RSU dokter soedarso pontianak periode 1 Januari 2008-31 Desember 2009 (Prevalence of osteoarthritis cases in RSU Dokter Soedarso Pontianak from 1 Januari 2008 – 31 Desember 2009). Jurnal Mahasiswa PSPD FK Universitas Tanjungpura, 1(1). Retrieved from php/jfk/article/view/1772/1716.

Grime, J., Richardson, J. C., & Ong, B. N. (2010). Perceptions of joint pain and feeling well in older people who reported being healthy: A qualitative study. British Journal of General Practice, 60, 597-603. doi: 10.3399/bjgp10X515106.

Conaghan, P. G., Porcheret, M., Kingsbury, S. R., Gammon, A., Soni, A., Hurley, M., ... & Llewelyn, K. (2015). Impact and therapy of osteoarthritis: The Arthritis Care OA Nation 2012 survey. Clinical Rheumatology, 34, 1581-1588. doi:10.1007/s10067-014-2692-1

Milano, J. V., Barbero, M. H., Basallote, S. G., Martín, J. V., Lladó, E. V., Serrano, H. M., ... & Díaz, J. J. (2016). Anxiety and depression in knee osteoarthritic patients: Results from emartro study. Osteoarthritis and Cartilage, 24, 218-219. doi: 10.1016/j.joca.2016.01.422

Keefe, F. J., Porter, L., Somers, T., Shelby, R., & Wren, A. V. (2013). Psychosocial interventions for managing pain in older adults: Outcomes and clinical implications. British Journal of Anesthesia, 111(1), 89-94. doi:10.1093/bja/aet129.

McAlindon, T. E., Bannuru, R., Sullivan, M. C., Arden, N. K., Berenbaum, F., Bierma-Zeinstra, S. M., ...&Kwoh, K. (2014). OARSI guidelines for the non-surgical management of knee osteoarthritis.Osteoarthritis and Cartilage, 22(3), 363-388. doi: 10.1016/j.joca.2014.01.003.

Basedow, M., Williams, H., Shanahan, E. M., Runciman, W. B., &Esterman, A. (2015).Australian GP management of osteoarthritis following the release of the RACGP guideline for the non-surgical management of hip and knee osteoarthritis. Bio Medical Care Research Notes, 8(1), 536. doi:10.1186/s13104-015-1531-z.

O'Neil, C. K., Hanlon, J. T., & Marcum, Z. A. (2012). Adverse effects of analgesics commonly used by older adults with osteoarthritis: Focus on non-opioid and opioid analgesics. The American Journal Of Geriatric Pharmacotherapy, 10(6), 331-342. doi: 10.1016/j.amjopharm.2012.09.004.

Sakalauskienė, G., & Jauniškienė, D. (2010). Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management. Medicina, 46, 790-797. Retrieved from

European League Against Rheumatism. (2012). EULAR recommendations for the non-pharmacological care management of hip and knee osteoarthritis. Retrieved from

Shakoor, M. A., Taslim, M. A., & Hossain, M. S. (2007). Effects of activity modification on the patients with osteoarthritis of the knee. Bangladesh Medical Research Council Bulletin, 33(2), 55-59. doi: 10.3329/bmrcb.v33i2.1205.

Fernandes, L., Hagen, K. B., Bijlsma, J. W., Andreassen, O., Christensen, P., Conaghan, P. G., ... & Lohmander, L. S. (2013). EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Annals of the Rheumatic Diseases, 72, 1125-1135. doi:10.1136/annrheumdis-2012-202745

Manaf, H. (2013). Barriers to participation in physical activity and exercise among middle-aged and elderly individuals. Singapore Medicine Journal, 54, 581-586. doi: 10.11622/smedj.2013203.

Kanfer, F. H. Gaelick-‐Buys, L.(1991). Self-‐management methods, Helping people change: A textbook of methods, 305-360. Retrieved from

Richard, A. A., & Shea, K. (2011). Delineation of self‐care and associated concepts. Journal of Nursing Scholarship, 43(3), 255-264. doi: 10.1111/j.1547-5069.2011.01404.x.

Coleman, S., Briffa, K., Conroy, H., Prince, R., Carroll, G., & McQuade, J. (2008). Short and medium-term effects of an education self-management program for individuals with osteoarthritis of the knee, designed and delivered by health.

Yip, Y. B., Sit, J. W., Fung, K. K., Wong, D., Chong, S. Y., Chung, L. H., & Ng, T. P. (2007). Effects of a self‐management arthritis programme with an added exercise component for osteoarthritic knee: Randomized controlled trial. Journal of Advanced Nursing, 59(1), 20-28. doi:10.1111/j.1365-2648.2007.04292.x.

Hurley, M. V., Walsh, N. E., Mitchell, H. L., Pimm, T. J., Patel, A., Williamson, E., ... & Reeves, B. C. (2007). Clinical effectiveness of a rehabilitation program integrating exercise, self‐management, and active coping strategies for chronic knee pain: A cluster randomized trial. Arthritis Care & Research, 57, 1211-1219. doi: 10.1002/art.22995

Carnes, D., Homer, K. E., Miles, C. L., Pincus, T., Underwood, M., Rahman, A., & Taylor, S. J. (2012). Effective delivery styles and content for self-management interventions for chronic musculoskeletal pain: A systematic literature review. The Clinical Journal of Pain, 28, 344-354. doi: 10.1097/AJP.0b013e31822ed2f3.

Fine, P. G. (2009). Chronic pain management in older adults: special considerations. Journal of Pain and Symptom Management, 38(2), 4-14. doi:10.1016/j.jpainsymman.2009.05.002.

Ng, N., Hakimi, M., Byass, P., Wilopo, S., & Wall, S. (2010). Health and quality of life among older rural people in Purworejo District, Indonesia. Global Health Action, 3(2), 78-87. Retrieved from

Stubbs, B., Hurley, M., & Smith, T. (2015). What are the factors that influence physical activity participation in adults with knee and hip osteoarthritis?: A systematic review of physical activity correlates. Clinical Rehabilitation, 29(1), 80-94. doi:10.1177/0269215514538069.

Hartmann, M., Bäzner, E., Wild, B., Eisler, I., & Herzog, W. (2010). Effects of interventions involving the family in the treatment of adult patients with chronic physical diseases: A meta-analysis. Psychotherapy and Psychosomatics, 79(3), 136-148.

Da Silva, F. S., de Melo, F. E., do Amaral, M. M., Caldas, V. V., & Pinheiro, Í. L. D. (2015). Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial. Journal of Rehabilitation Research and Development, 52(3), 309-321.


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Last updated: 13 February 2019