Niedermann Karin, Buchi Stefan, Ciurea Adrian, Kubli Regula, Steurer-Stey Claudia, Villiger Peter M, De Bie Rob A
Department of Health, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
Scand J Occup Ther. 2012 Jul;19(4):360-9. doi: 10.3109/11038128.2011.611820. Epub 2011 Sep 22.
Joint protection (JP) education for people with rheumatoid arthritis (RA) is effective when applying psycho-educational teaching strategies. The Pictorial Representation of Illness and Self Measure (PRISM) was used to identify relevant JP education goals and life aspects, both supporting motivation and behaviour change. The objective of this study was to compare the effects of individual JP education, PRISM-based (PRISM-JP) vs. conventional (C-JP), in people with rheumatoid arthritis (RA).
An assessor-blinded randomized controlled trial was conducted in four rheumatology centres. Patients were randomized to PRISM-JP or C-JP, consisting of five JP education sessions over three months. Primary outcome was JP behaviour at six and 12 months.
A total of 53 RA patients participated. The PRISM-JP group (n = 26) demonstrated significantly more JP behaviour at six months (effect size ES = 0.32; p = 0.02) and 12 months (ES = 0.28; p = 0.04) than the C-JP (n = 27). Within-group analysis showed that the JP intervention was successful at six and 12 months in both groups (p < 0.001). At 12 months the PRISM-JP group had better JP self-efficacy (p = 0.02) and grip strength (p = 0.04) compared with baseline.
PRISM-JP was more effective than C-JP in terms of long-term JP behaviour at six and 12 months.
对类风湿关节炎（RA）患者采用心理教育教学策略进行关节保护（JP）教育是有效的。疾病与自我测量的图片表征（PRISM）被用于确定相关的JP教育目标和生活方面，这两者都有助于激发动力和改变行为。本研究的目的是比较类风湿关节炎（RA）患者接受基于PRISM的个体JP教育（PRISM-JP）与传统JP教育（C-JP）的效果。
在四个风湿病中心进行了一项评估者盲法随机对照试验。患者被随机分为PRISM-JP组或C-JP组，在三个月内进行五次JP教育课程。主要结局是6个月和12个月时的JP行为。
共有53例RA患者参与。PRISM-JP组（n = 26）在6个月时（效应量ES = 0.32；p = 0.02）和12个月时（ES = 0.28；p = 0.04）的JP行为明显多于C-JP组（n = 27）。组内分析表明，两组在6个月和12个月时的JP干预均成功（p < 0.001）。与基线相比，PRISM-JP组在12个月时具有更好的JP自我效能感（p = 0.02）和握力（p = 0.04）。
在6个月和12个月的长期JP行为方面，PRISM-JP比C-JP更有效。
