Religious coping and daily pain experience in osteoarthritis: a moderated mediation model
Objective: The current study explores the role of religious coping in the daily pain experience of African American and non-Hispanic White older adults with physician-confirmed knee osteoarthritis (OA). Methods: As part of a larger study of racial/ethnic differences in everyday quality of life with OA, 116 persons over the age of 50 completed global measures of pain (PGC Pain Scale) and religious coping (Brief RCOPE); daily variability in pain, coping, and affect was assessed using a daily diary methodology consisting of 4 daily phone calls over 7 days. Multilevel modeling was used to explore moderated-mediation effects of religious coping variables on the daily pain experience. Results: Participant demographics (race, sex) were only partially predictive of religious coping behaviors. A high intraclass correlation (ICC = .92) indicated minimal within-person variation in religious coping over the course of the week. Accordingly, analyses yielded no significant predictive power of level-1 variables (daily pain severity, daily religious coping). Bimodal distributions for daily religious coping suggest minimal variation between coping daily (31.9%) or not at all (31.9%). Inclusion of level-2 variables in the model demonstrated a significant moderating effect of coping type (positive vs. negative) on the relationship between the employment of religious coping and negative affect reported that day (b = .096, SE = .043, p = .028). Conclusions: Findings suggest that employment of religious coping strategies is more closely tied to person-level belief systems than within-day factors. Though challenging to measure on a daily basis, person-level endorsement of religious coping was closely associated with global measures of pain and disability. Implications for future research and clinical intervention are discussed.