The Effects of a Symptom Management Program on Disease Severity and Self-care Behaviors of Elderly People with Risk of Primary Knee Osteoarthritis


  • Kanyapat Prabripoo คณะพยาบาลศาสตร์ มหาวิทยาลัยคริสเตียน
  • Sasitorn Roojanavech
  • Nongpimol Nimit-arnun


Elderly, Knee osteoarthritis, Symptom management program, Resistanceelastic band exercise


This quasi-experimental research, two group pretest-posttest design aimed to study the effects of Primary Knee Osteoarthritis Symptom Management Program among elderly at risk group in Nakhon Pathom province. The 58 samples were selected by purposive sampling and divided into experimental group and comparison group, there were 29 persons in each group. The experimental group received 8 weeks of the Osteoarthritis Symptom Management Program that was applied fromthe Symptom Management Model which consisted of four stages; 1) group learning, 2) resistanceelastic band exercise, 3) telephone visit monitoring, and 4) knowledge sharing and feedback of symptom management outcomes. The research instrument was composed of demographic data, osteoarthritis severity perception, and self-care behaviors questionnaires, the last two's reliability was 0.78 and 0.70, respectively. The data were analyzed using descriptive statistics, paired t-test and independent t-test. The research results revealed that after joining the intervention program, the experimental group had statistically significant lower mean score of disease severity and higher mean sore of self-care behaviors than before joining the program, this also the same in the comparison group (p < 0.05). The researcher recommend that nurse practitioners and public health personnel should apply the intervention program for health promotion activities for community-dwelling elderly group for the progressive delaying of disease and quality of life improvement.


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Aguiar, G.C., Rocha, S.G., Rezende, G.A., Nascimento, M.R., & Scalzo, P.L. (2016). Effects of resistance training in individuals with knee osteoarthritis. Fisioterapia em Movimento, Curitiba, 29(3), 589-596.

Allen, K.D., & Golightly, Y.M. (2015). Epidemiology of osteoarthritis: state of the evidence. Current Opinion in Rheumatology, 27(3), 276-283.

Allen, K.D., Bongiorni, D., Bosworth, H.B., Coffman, C.J., Datta, S.K., Edelman, D... Hoenig, H. (2016). Group versus individual physical therapy for veterans with knee osteoarthritis: Randomized clinical trial. Physical Therapy, 96(5), 597-608.

American Academy of Orthopedic Surgeons. [AAOS]. (2013). Treatment of osteoarthritis of the knee: Evidence-based guideline. Retrieved 10 June 2018 from www.aaos.Org/ research /guidelines/Guideline OAKnee.asp.

American College of Sport Medicine. (2006). ACSM’s guidelines for exercise testing and prescription (7th ed.). Philadelphia: Lippincott Williams & Wilkins.

Blagojevic, M., Jinks, A., Jeffery, A., & Jordan, K.P. (2010). Risks factors for onset of osteoarthritis in older adults: A systematic review and meta-analysis. Osteoarthritis and Cartilage, 18(1), 24 – 33.

Chang, T.F., Liou, T.H., Chen, C.H., Huang, Y.C., & Chang, K.H. (2012). Effects of elastic band exercise on lower- extremity function among female patients with osteoarthritis of the knee. Disabil Rehabil, 34(20), 1727-1735.

Charoenchonwanit, K., & Pongcharoen, B. (2005). The study of reliability of life quality assessment questionnaire, Oxford Knee score and SF-16. Journal of the Medical Association of Thailand, 88(9), 1194-1202. [In Thai].

Chen, A., Gupte, C., Akhtar, K., Smith, P., & Cobb, J. (2012). The global economic cost of osteoarthritis: how the UK compares. Arthritis, 2012(1), 1-6.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

Cooper, C., Denni, son E., Edwards, M., & Litwic, A. (2013). Epidemiology of osteoarthritis. Medicographia, 35, 145-151.

Dodd, M., Janson, S., Facione, N., Faucett, J., Froelicher, E. S., Humphreys, J...Taylor, D. (2001). Advancing the science of symptom management. Journal of Advanced Nursing, 33(5), 668-676.

Jitapunkul, S. (1994). Disability: A problem of the elderly. Chulalongkorn Medical Journal, 38(2), 67-75. [In Thai].

Krabuanrat, J. (2008). Exercise for health: knowledge and understanding of the needs. Journal of Nutrition, Kasetsart University, 19, 88-102. [In Thai].

Kunsonwet, P., Hoontrakul, S., & Nimit-arnun, N. (2018). The effects of primary knee osteoarthritis prevention empowerment program for village health volunteers at a community in Phetchaburi Province. Royal Thai Navy Medical Journal, 45(3), 578-598. [In Thai].

Nimit-arnun, N., & Roojanavech, S. (2014). An integrative review of non-pharmacological therapy in the patients with primary knee osteoarthritis. APHEIT Journal, 3(1), 35-49. [In Thai].

Nimit-arnun, N., Roojanavech, S., & Pochanapun, S. (2018). Effectiveness of health promoting program for teachers at risk of knee osteoarthritis in Nakhon Pathom Primary Educational Service Area Office II. The Journal of Faculty of Nursing Burapha University, 2(6), 50-59. [In Thai].

Palazzo, C., Nguyen, C., Lefevre-Colau, M.M., Rannou, F., & Poiraudeau, S. (2016). Risk factors and burden of osteoarthritis. Annals of Physical and Rehabilitation Medicine, 59(3), 134-138.

Peebanta, C., Thiamwong, L., Suwanno, J., & Samienpetch, T. (2012). Management of knee pain in primary care: A nurse practitioner project. Journal of gerontology and geriatric medicine, 13(1), 1-10. [In Thai].

Pereira, D., Peleteiroa, B., Araújoa, J., Brancoa, J., Santosa, A.R., & Ramos, E. (2011). The effect of osteoarthritis definition on prevalence and incidence estimates: A systematic review. Osteoarthritis and Cartilage, 19(11), 1270-1285.

Richmond, J. (2013). The treatment of osteoarthritis in the middle-aged athlete. Sports Medicine and Arthroscopy Review, 21(1), 1.

Sayantiya, D., & Shabnam, A. (2015). Effectiveness of elastic band exercise protocol in tri-compartmental osteoarthritis of the knee. Indian Journal of Physiotherapy and Occupational Therapy, 9(2), 176-181.

Saurja, T., Robert, H.S., Jonathan F.B., Yurun, C., & Suzanne G.L. (2019). Chronic multisite pain: evaluation of a new geriatric syndrome Aging clinical and experimental research, 31(8), 1129–1137.

Simanta, D., Tudpor, K., & Prasomruk, P. (2018). Effects of an exercise with elastic chain and health promotion behavior on delaying osteoarthritis of knee among elderly in Kudhae subdistrict, Loengnoktha district, Yasothon province. Journal of Nursing and Health Care, 36(2), 41-48. [In Thai].

Tantapong, U., Nimit-arnun, N., & Roojanavech, S. (2019). The selected factors affecting to health-preventive behaviors of primary knee osteoarthritis among teachers in Nakhon Pathom Province, Journal of The Royal Thai Army Nurses, 20(2), 316-326. [In Thai].

Tehlong, N. (2013). The effect of symptom management program on quality of life among knee osteoarthritis patients. Master Thesis (Community Nurse Practitioner), Naresuan Uiversity, Phitsanulok. [In Thai].

Thapa, S., Shmerling, R.H., Bean,J.F., Cai, Y., & Leveille, S.G. (2019). Chronic multisite pain: evaluation of a new geriatric syndrome. Aging Clinical and Experimental Research, 31(8), 1129-1137.

The Royal Australian College of General Practitioners (RACGP). (2018). Guideline for the management of knee and hip osteoarthritis (2nd ed.). Retrieved 8 May 2019 from

The Royal College of Orthopedic Surgeons of Thailand (RCOST). (2011). Guideline for the Treatment of Osteoarthritis of Knee. Retrieved 19 Aug 2018 from

Thinchana, N., Naka, K.,& Srikaew, M. (2018). Effects of home exercise promoting program using a stretched rubber band on the physical fitness of the elderly. Songklanagarind Journal of Nursing, 38(2), 70-78. [In Thai].

United Nations. (2017). World population ageing. Retrieved 2 July 2017 from

Vina, E. R., & Kwoh, C. K. (2018). Epidemiology of osteoarthritis: Literature update. Current Opinion in Rheumatology, 30(2), 160–167.

Vincent, K.R., & Vincent, H.K. (2012). Resistance exercise for knee osteoarthritis. American Academy of Physical Medicine and Rehabilitation, 4(5 Suppl), S45-S52.




How to Cite

Prabripoo, K. ., Roojanavech, S. ., & Nimit-arnun, N. . (2020). The Effects of a Symptom Management Program on Disease Severity and Self-care Behaviors of Elderly People with Risk of Primary Knee Osteoarthritis. NU Journal of Nursing and Health Sciences, 14(1), 24–37. Retrieved from