自我管理训练对类风湿关节炎患者生活质量、药物依从性和自我效能的影响

IF 1.8 Q3 NURSING International Journal of Orthopaedic and Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-04-01 DOI:10.1016/j.ijotn.2025.101178
Puvaneswari Kanagaraj
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引用次数: 0

摘要

类风湿性关节炎(RA)可导致严重的关节破坏和工作残疾,需要身体和心理调节来应对疼痛和疲劳。方法采用平行实验设计,采用前测后候列对照组,评估自我管理训练对RA患者生活质量、药物依从性和自我效能感的影响。研究人员将参与者随机分为研究组(70人)和对照组(70人)。研究组接受了为期12周的6次自我管理培训,而对照组接受常规护理。重要的是,负责结果评估的研究助理使用Short form- 36、依从性问卷、风湿病和关节炎自我效能量表对干预后第1、3和5个月的治疗分配保持盲法。结果SMT显著改善了QoL-physical components,包括Pain (p = 0.001,偏eta平方(η²)= 0.372)和General Health (p = 0.001, η²= 0.320)。疼痛组间差异有统计学意义(p = 0.007),其他组间差异无统计学意义。研究组的心理健康成分也有显著改善,特别是在能量方面(p = 0.001, η²= 0.344)。药物依从性最初有所改善,但随着时间的推移稳定下来。研究组在疼痛、功能和其他症状的自我效能方面有显著改善(p <;0.009),效应量大且进展持续。结论通过增强患者的知识、技能和信心来有效地管理自己的病情,这种健康教育有助于显著改善整体健康状况。
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Impact of self-management training on quality of life, medication adherence, and self-efficacy among rheumatoid arthritis patients

Introduction

Rheumatoid Arthritis(RA) can result in significant joint destruction and work disability which needs physical and psychosocial adjustment to deal with pain, and fatigue.

Methods

True experimental parallel arm design with a pre-test post-test wait-listed control group was used to assess the impact of self-management training on Quality of life, medication adherence and self-efficacy among patients with RA. Participants were randomly allocated to the study(70) or control(70)group by simple randomization by the researcher. The study group underwent a self-management training consisting of six sessions over a 12-week period, while the control group received routine care. Importantly, the research assistant responsible for outcome assessment remained blinded to the treatment allocation at 1st, 3rd and 5th month post intervention using Short form- 36, Compliance Questionnaire, Rheumatology and Arthritis self efficacy scale.

Results

The SMT led to significant improvements in QoL-physical components including Pain (p = 0.001, partial eta squared(η²) = 0.372) and General Health (p = 0.001, η² = 0.320). Significant between-group differences were observed for Pain (p = 0.007), while other measures showed no differences. Mental health components also improved significantly in the study group, particularly in Energy (p = 0.001, η² = 0.344). Medication adherence improved initially but stabilized over time. The study group showed significant improvements in self-efficacy for pain, function, and other symptoms (p < 0.009), with large effect sizes and sustained progress.

Conclusion

By empowering patients with knowledge, skills, and confidence to effectively manage their condition, such health educations can contribute significantly improve overall health outcomes.
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来源期刊
CiteScore
2.60
自引率
14.30%
发文量
34
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