Hainsworth J, Barlow J
Psychosocial Research Centre: Chronic Conditions & Disability, Self-Management & Intervention Group, School of Health & Social Sciences, Coventry University, UK.
Arthritis Rheum. 2001 Aug;45(4):378-83. doi: 10.1002/1529-0131(200108)45:4<378::AID-ART351>3.0.CO;2-T.
To determine whether undergoing training to become a lay leader and conducting an arthritis self-management course is associated with improvements in physical and psychological health status, arthritis self-efficacy, use of self-management techniques, and visits to the general practitioner. In addition, we aimed to describe the experiences of training and course delivery from the older volunteers' perspective.
21 participants completed all assessments and had a median age of 58, median disease duration of 10 years, and either osteoarthritis (n = 13) or rheumatoid arthritis (n = 8). The study was a pretest-posttest design with qualitative data collected at 3 points in time: before training, 6 weeks after training, and 6 months after training. Quantitative data were collected through self-administered postal questionnaires at baseline and 6-month followup.
Six months after training, participants reported small, significant increases in arthritis self-efficacy for pain (P = 0.002), cognitive symptom management (P = 0.004), and communication with their physician (P = 0.024) and a small, significant decrease in depressed mood (P = 0.04). Qualitative data supported these findings, with participants reporting more confidence, happiness, and a changed outlook on life in general. Volunteerism was associated with altruistic behavior and with filling the vocational void caused by retirement.
Findings support the value of volunteerism and training to become lay leaders in arthritis self-management programs. Volunteers reported positive changes both in themselves and in course participants. They enjoyed helping similar others and being involved in a worthwhile activity, and they valued their newly acquired status as lay leaders. Many had begun to apply their newfound knowledge about self-management to their own situation, reporting less pain and more willingness "to get on with life."
确定接受培训成为非专业领导者并开展关节炎自我管理课程是否与身体和心理健康状况的改善、关节炎自我效能感、自我管理技巧的使用以及看全科医生的次数有关。此外,我们旨在从老年志愿者的角度描述培训和课程实施的经历。
21名参与者完成了所有评估,年龄中位数为58岁,疾病持续时间中位数为10年,其中骨关节炎患者13名,类风湿关节炎患者8名。该研究采用前后测设计,在三个时间点收集定性数据:培训前、培训后6周和培训后6个月。定量数据通过在基线和6个月随访时自行邮寄的问卷收集。
培训6个月后,参与者报告在疼痛的关节炎自我效能感(P = 0.002)、认知症状管理(P = 0.004)以及与医生沟通方面(P = 0.024)有小幅但显著的提高,抑郁情绪有小幅但显著的下降(P = 0.04)。定性数据支持了这些发现,参与者报告总体上更有信心、更快乐,人生观也有所改变。志愿服务与利他行为以及填补退休导致的职业空白有关。
研究结果支持志愿服务和培训成为关节炎自我管理项目非专业领导者的价值。志愿者报告自身以及课程参与者都有积极变化。他们喜欢帮助他人并参与有意义的活动,并且重视自己作为非专业领导者的新身份。许多人已开始将新获得的自我管理知识应用于自身情况,报告疼痛减轻,更愿意“继续生活”。