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自我效能和身体活动目标达成对类风湿关节炎患者关节炎疼痛和生活质量的影响。

Effect of self-efficacy and physical activity goal achievement on arthritis pain and quality of life in patients with rheumatoid arthritis.

机构信息

Leiden University, The Netherlands.

出版信息

Arthritis Care Res (Hoboken). 2011 Nov;63(11):1613-9. doi: 10.1002/acr.20587.

Abstract

OBJECTIVE

To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA).

METHODS

At baseline, 271 patients with RA were asked to specify a physical activity goal, and filled in questionnaires assessing physical activity, motivation, and self-efficacy for physical activity, arthritis pain, and quality of life. Six months later, patients indicated to what extent they had achieved their baseline physical activity goal and completed the same set of questionnaires. These data were used to construct multiple mediation models that placed physical activity and physical activity goal achievement as mediators between self-efficacy and motivation on one hand, and arthritis pain and quality of life on the other.

RESULTS

A total of 106 patients with RA completed both questionnaires. Self-efficacy at baseline predicted subsequent level of physical activity and achievement of physical activity goals. Goal achievement had a direct effect upon quality of life outcomes. Bootstrapping confidence intervals revealed indirect effects of self-efficacy upon arthritis pain and quality of life through goal achievement, but not through physical activity.

CONCLUSION

Higher levels of self-efficacy for physical activity increase the likelihood that patients will achieve their physical activity goals. Achievement of physical activity goals seems to be related to lower self-reported arthritis pain, and higher levels of quality of life. In practice, clinicians can foster self-efficacy and goal achievement by assisting patients in setting realistic and attainable exercise goals, developing action plans, and by providing feedback on goal progress.

摘要

目的

研究类风湿关节炎(RA)患者的体力活动与体力活动目标的实现与自我报告的疼痛和生活质量之间的关系。

方法

在基线时,271 名 RA 患者被要求指定一个体力活动目标,并填写评估体力活动、动机和体力活动自我效能感、关节炎疼痛和生活质量的问卷。6 个月后,患者指出他们在多大程度上实现了基线体力活动目标,并完成了相同的问卷集。这些数据被用来构建多个中介模型,将体力活动和体力活动目标的实现作为中介,置于自我效能感和动机与关节炎疼痛和生活质量之间。

结果

共有 106 名 RA 患者完成了两份问卷。基线时的自我效能感预测了随后的体力活动水平和体力活动目标的实现。目标的实现对生活质量结果有直接影响。Bootstrapping 置信区间显示,自我效能感通过目标实现对关节炎疼痛和生活质量有间接影响,但通过体力活动没有间接影响。

结论

较高的体力活动自我效能感增加了患者实现体力活动目标的可能性。体力活动目标的实现似乎与自我报告的关节炎疼痛降低和生活质量提高有关。在实践中,临床医生可以通过帮助患者设定现实可行的锻炼目标、制定行动计划以及提供目标进展反馈来促进自我效能感和目标的实现。

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