Freeman K, Hammond A, Lincoln N B
Division of Physiotherapy Education, University of Nottingham, Nottingham City Hospital, Nottingham, UK.
Clin Rehabil. 2002 Dec;16(8):828-36. doi: 10.1191/0269215502cr565oa.
To identify the effect of attending a cognitive-behavioural arthritis education programme on the health status of participants with newly diagnosed rheumatoid arthritis (RA) compared with a control group.
Randomized controlled trial.
Hospital based.
Newly diagnosed with RA.
Participation in either a cognitive-behavioural arthritis education programme or a standard arthritis education programme (control group). Sessions for both groups lasted for 2 hours per week for four weeks. Subjects were examined at home by an assessor blinded to group allocation, prior to and three and six months following attendance.
The main outcome measure was the Physical Function subscale of the Arthritis Impact Measurement Scale Two. Other outcome measures included erythrocyte sedimentation rate (ESR), joint count scores, assessments of pain and psychological status.
Fifty-four subjects (mean time since diagnosis 4.5 months) took part. Baseline analysis revealed that the control group had significantly better levels of functional ability (U = 185; p = 0.009) and lower levels of helplessness (U = 168; p = 0.002) prior to intervention. This difference remained unchanged three months later. Six months following the intervention no significant differences were noted between the groups for any measure of health status. There were no significant changes in health status over time in either group.
Attending a cognitive-behavioural arthritis education programme had no significant effect on the health status of individuals newly diagnosed with RA. The move to early use of these programmes should be examined further, with a larger sample size and longer duration of follow-up.
与对照组相比，确定参加认知行为性关节炎教育项目对新诊断为类风湿性关节炎（RA）患者健康状况的影响。
随机对照试验。
以医院为基础。
新诊断为RA的患者。
参加认知行为性关节炎教育项目或标准关节炎教育项目（对照组）。两组的课程均为每周2小时，共四周。在参加项目之前、之后三个月和六个月，由对分组不知情的评估人员在患者家中进行检查。
主要观察指标为关节炎影响测量量表二的身体功能分量表。其他观察指标包括红细胞沉降率（ESR）、关节计数得分、疼痛评估和心理状态评估。
54名受试者（诊断后平均时间为4.5个月）参与了研究。基线分析显示，干预前对照组的功能能力水平显著更高（U = 185；p = 0.009），无助感水平更低（U = 168；p = 0.002）。三个月后这种差异保持不变。干预六个月后，两组在任何健康状况指标上均未发现显著差异。两组的健康状况随时间均无显著变化。
参加认知行为性关节炎教育项目对新诊断为RA的个体的健康状况没有显著影响。应进一步研究尽早采用这些项目的情况，增加样本量并延长随访时间。
