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掌控疼痛:评估一项针对肌肉骨骼疼痛患者的社区自我管理教育项目。

Take Charge of Pain: evaluating a community-targeted self-management education program for people with musculoskeletal pain.

作者信息

Hoon Elizabeth, Smith Karen, Black Julie, Burnet Simon, Hill Catherine, Gill Tiffany K

机构信息

School of Public Health, The University of Adelaide, Mail Drop DX 650 205, SA 5005, Australia.

Arthritis SA, 118 Richmond Road, Marleston, SA 5033, Australia.

出版信息

Health Promot J Austr. 2017 Mar;28(1):77-80. doi: 10.1071/HE15123.

Abstract

Issue addressed Musculoskeletal conditions are highly prevalent, affecting 28% of the Australian population. Given the persistent nature of many musculoskeletal conditions self-management is recognised as an important aspect of effective disease management. However, participant recruitment and retention for formal self-management programs is a challenge. Methods Arthritis SA (Arthritis Foundation of South Australia, a non-profit community health organisation) redesigned a shorter, community-orientated self-management education program delivered by health professionals. The program utilises aspects of the Stanford model of chronic disease self-management and motivational interviewing as well as principles of adult learning to create an effective learning environment. The program aims to guide participants to learn and practise a range of pain management strategies that are known to be effective in improving quality of life. This study used a pre- and post-test (at 6 weeks) design to determine whether this program achieved benefits in self-reported health outcomes. Outcomes that were measured included pain, fatigue, health distress, self-efficacy and communication. Results A response rate of 47% (n=102) was achieved and small but statistically significant improvements in mean [s.d.] pain scores (6.1 [2.3] to 5.4 [2.4], P=0.001), health distress (2.3 [1.3] to 2.0 [1.3], P=0.002) and self-efficacy (6.2 [2.1] to 6.8 [2.2], P=0.002) were found. Conclusion Community-based participants of this shorter, focused program recorded small but significant improvements in self-reported pain, health distress and self-efficacy. For those who completed the current program, Arthritis SA is currently exploring the potential of developing a booster session to promote sustainable positive health outcomes. So what? Supporting self-management through education is recognised as important but also as a key challenge for effective management of musculoskeletal conditions. Using a pre-post evaluation design, this study demonstrated effectiveness (short-term improvements for self-reported pain, health distress and self-efficacy) for a redesigned and shortened community-targeted program focusing on musculoskeletal pain.

摘要

解决的问题

肌肉骨骼疾病非常普遍,影响了28%的澳大利亚人口。鉴于许多肌肉骨骼疾病的持续性,自我管理被认为是有效疾病管理的一个重要方面。然而,正式自我管理项目的参与者招募和留存是一项挑战。

方法

南澳大利亚关节炎协会(南澳大利亚关节炎基金会,一个非营利性社区健康组织)重新设计了一个由健康专业人员提供的更短的、以社区为导向的自我管理教育项目。该项目利用了慢性病自我管理的斯坦福模式和动机访谈的方面,以及成人学习原则来创造一个有效的学习环境。该项目旨在指导参与者学习和实践一系列已知对改善生活质量有效的疼痛管理策略。本研究采用前后测试(6周时)设计,以确定该项目是否在自我报告的健康结果方面取得了益处。测量的结果包括疼痛、疲劳、健康困扰、自我效能感和沟通。

结果

实现了47%(n = 102)的回复率,并且发现平均[标准差]疼痛评分(6.1 [2.3]至5.4 [2.4],P = 0.001)、健康困扰(2.3 [1.3]至2.0 [1.3],P = 0.002)和自我效能感(6.2 [2.1]至6.8 [2.2],P = 0.002)有虽小但具有统计学意义的改善。

结论

参与这个更短、更有针对性项目的社区参与者在自我报告的疼痛、健康困扰和自我效能感方面有虽小但显著的改善。对于那些完成当前项目的人,南澳大利亚关节炎协会目前正在探索开展强化课程以促进可持续积极健康结果的潜力。

那又如何?通过教育支持自我管理被认为很重要,但也是有效管理肌肉骨骼疾病的一个关键挑战。使用前后评估设计,本研究证明了一个重新设计和缩短的以社区为目标、专注于肌肉骨骼疼痛的项目的有效性(自我报告的疼痛、健康困扰和自我效能感的短期改善)。

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