Branch V K, Lipsky K, Nieman T, Lipsky P E
Rheumatic Diseases Division, University of Texas Southwestern Medical Center at Dallas 75235-8884, USA.
Arthritis Care Res. 1999 Dec;12(6):370-5. doi: 10.1002/1529-0131(199912)12:6<370::aid-art4>3.0.co;2-q.
The goal of the study was to determine whether an intervention by a trained arthritis patient educator could have a positive impact on the health status, knowledge, and satisfaction with services of arthritis patients attending an ambulatory rheumatology care clinic by providing education and support.
One hundred eight arthritis patients were randomly assigned to have an intervention by an arthritis patient educator as well as standard rheumatologic care (n = 47) or were assigned to the control group receiving only standard rheumatologic care (n = 61). Both groups completed the Arthritis Impact Measurement Scales 2 and the Arthritis Self-Efficacy Scale at baseline arrival to the clinic. After the appointment with the rheumatologist, each patient of the study group met with an arthritis patient educator. This session included educational and social support. A week later this group of patients received a followup telephone call from an arthritis patient educator to determine whether the patient had unanswered questions or needed additional support. Eight weeks later, both groups completed the baseline questionnaire again, a basic arthritis knowledge test, and a satisfaction survey.
Eight weeks after the interventions, basic knowledge scores, on a scale of 1 to 8, were significantly different for the study group and the control group (6.48 +/- 0.31 versus 5.35 +/- 0.35, respectively, P = 0.02). A greater percentage of patients who received the intervention by an arthritis patient educator was able to identify two of the educational resources available to them compared with patients in the control group (92.6 +/- 0.05% versus 64.50 +/- 0.08%, P = 0.015, 77.7 +/- 0.08% versus 54.8 +/- 0.09%, P = 0.041). A greater percentage of persons in the active intervention group was also able to identify one self-help aid compared with the control group (88.8 +/- 0.06% versus 67.74 +/- 0.08%, P = 0.028). Overall satisfaction with care was rated "good" or "excellent" more often by the study group when compared with the control group (88.5 +/- 0.24% versus 61.3 +/- 0.32%, P = 0.01). Of the study group, 69% found the session helpful, and 58% desired further interactions; 16% of the control group also requested future appointments with the arthritis patient educators.
Arthritis patient educators can provide a meaningful and useful addition to traditional rheumatology care, positively affecting patient knowledge and satisfaction with clinic services.
本研究的目的是确定经过培训的关节炎患者教育者进行的干预，能否通过提供教育和支持，对在门诊风湿病护理诊所就诊的关节炎患者的健康状况、知识水平以及对服务的满意度产生积极影响。
108名关节炎患者被随机分为两组，一组接受关节炎患者教育者的干预以及标准的风湿病护理（n = 47），另一组被分配到仅接受标准风湿病护理的对照组（n = 61）。两组患者在首次到诊所就诊时均完成了关节炎影响测量量表2和关节炎自我效能量表。在与风湿病专家预约就诊后，研究组的每位患者与一名关节炎患者教育者会面。这次会面包括教育和社会支持。一周后，该组患者接到了关节炎患者教育者的随访电话，以确定患者是否有未解答的问题或需要额外的支持。八周后，两组患者再次完成了基线调查问卷、一项基本的关节炎知识测试和一项满意度调查。
干预八周后，研究组和对照组在1至8分的基础知识得分上存在显著差异（分别为6.48±0.31和5.35±0.35，P = 0.02）。与对照组患者相比，接受关节炎患者教育者干预的患者中，能够识别出两种可用教育资源的比例更高（分别为92.6±0.05%和64.50±0.08%，P = 0.015；77.7±0.08%和54.8±0.09%，P = 0.041）。与对照组相比，积极干预组中能够识别出一种自助辅助工具的人员比例也更高（分别为88.8±0.06%和67.74±0.08%，P = 0.028）。与对照组相比，研究组对护理的总体满意度更多地被评为“良好”或“优秀”（分别为88.5±0.24%和61.3±0.32%，P = 0.01）。在研究组中，69%的患者认为这次会面有帮助，58%的患者希望进一步交流；对照组中有16%的患者也请求未来与关节炎患者教育者预约就诊。
关节炎患者教育者可以为传统的风湿病护理提供有意义且有用的补充，对患者的知识水平和对诊所服务的满意度产生积极影响。
