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基于互联网的自我管理计划结合电话支持治疗青少年关节炎:一项随机对照试验的初步研究。

An internet-based self-management program with telephone support for adolescents with arthritis: a pilot randomized controlled trial.

机构信息

Child Health Evaluative Sciences, Chronic Pain Program, Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.

出版信息

J Rheumatol. 2010 Sep;37(9):1944-52. doi: 10.3899/jrheum.091327. Epub 2010 Jul 1.

Abstract

OBJECTIVE

To determine the feasibility of a 12-week Internet-based self-management program of disease-specific information, self-management strategies, and social support with telephone support for youth with juvenile idiopathic arthritis (JIA) and their parents, aimed at reducing physical and emotional symptoms and improving health-related quality of life (HRQOL).

METHODS

A nonblind pilot randomized controlled trial (NCT01011179) was conducted to test the feasibility of the "Teens Taking Charge: Managing Arthritis Online" Internet intervention across 4 tertiary-level centers in Canada. Participants were 46 adolescents with JIA, ages 12 to 18 years, and 1 parent for each participant, who were randomized to the control arm (n = 24) or the Internet intervention (n = 22).

RESULTS

The 2 groups were comparable on demographic and disease-related variables and treatment expectation at baseline. Attrition rates were 18.1% and 20.8%, respectively, from experimental and control groups. Ninety-one percent of participants randomized to the experimental group completed all 12 online modules and weekly phone calls with a coach in an average of 14.7 weeks (SD 2.1). The control group completed 90% of weekly attention-control phone calls. The Internet treatment was rated as acceptable by all youth and their parents. In posttreatment the experimental group had significantly higher knowledge (p < 0.001, effect size 1.32) and lower average weekly pain intensity (p = 0.03, effect size 0.78). There were no significant group differences in HRQOL, self-efficacy, adherence, and stress posttreatment.

CONCLUSION

Findings support the feasibility (acceptability, compliance, and user satisfaction) and initial efficacy of Internet delivery of a self-management program for improving disease-specific knowledge and reducing pain in youth with JIA.

摘要

目的

确定 12 周基于互联网的疾病特定信息、自我管理策略和社会支持的自我管理计划的可行性,为青少年特发性关节炎(JIA)患者及其父母提供电话支持,以减轻身体和情绪症状,提高健康相关生活质量(HRQOL)。

方法

一项非盲随机对照试验(NCT01011179)在加拿大 4 个三级中心进行,以测试“青少年负责:在线管理关节炎”互联网干预的可行性。参与者为 46 名 12 至 18 岁的青少年特发性关节炎患者和每位参与者的 1 名家长,他们被随机分配到对照组(n = 24)或互联网干预组(n = 22)。

结果

两组在人口统计学和疾病相关变量以及基线治疗预期方面具有可比性。实验组和对照组的失访率分别为 18.1%和 20.8%。随机分配到实验组的 91%的参与者完成了所有 12 个在线模块和每周与教练的电话通话,平均用时 14.7 周(SD 2.1)。对照组完成了 90%的每周注意力控制电话通话。互联网治疗被所有青少年及其父母评为可接受。在治疗后,实验组的知识得分显著提高(p < 0.001,效应量 1.32),每周平均疼痛强度显著降低(p = 0.03,效应量 0.78)。治疗后两组在 HRQOL、自我效能、依从性和压力方面均无显著差异。

结论

研究结果支持互联网提供自我管理计划的可行性(可接受性、依从性和用户满意度)和初步疗效,以改善青少年特发性关节炎患者的疾病特异性知识和减轻疼痛。

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