Objective-Previous studies suggest that higher mindfulness is associated with less pain and depression. However, the role of mindfulness has never been studied in knee osteoarthritis (OA). We evaluate the relationships between mindfulness and pain, psychological symptoms, and quality of life in knee OA. Method-We performed a secondary analysis of baseline data from our randomized comparative trial in participants with knee OA. Mindfulness was assessed using the Five Facet Mindfulness

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... re. We measured pain, physical function, quality of life, depression, stress, and selfefficacy with commonly-used patient-reported measures. Simple and multivariable regression models were utilized to assess associations between mindfulness and health outcomes. We further tested whether mindfulness moderated the pain-psychological outcome associations. Results-Eighty patients were enrolled (60.3±10.3 years;76.3% female, body mass index: 33.0±7.1kg/m 2 ). Total mindfulness score was associated with mental (beta=1.31,95% CI: 0.68,1.95) and physical (beta=0.69,95% CI:0.06,1.31) component quality of life, self-efficacy (beta=0.22,95% CI:0.07,0.37), depression (beta=-1.15,95% CI:-1.77,-0.54), and stress (beta=-1.07,95% CI:-1.53,-0.60). Of the five facets, the Describing, Acting-with-Awareness, and Non-judging mindfulness facets had the most associations with psychological health. No significant association was found between mindfulness and pain or function (P=0.08-0.24). However, we found that mindfulness moderated the effect of pain on stress (P=0.02). Conclusion-Mindfulness is associated with depression, stress, self-efficacy, and quality of life among knee OA patients. Mindfulness also moderates the influence of pain on stress, which suggests that mindfulness may alter the way one copes with pain. Future studies examining the benefits of mind-body therapy, designed to increase mindfulness, for patients with OA are warranted.