University of Michigan, Ann Arbor.
Medical University of South Carolina, Charleston.
Arthritis Care Res (Hoboken). 2019 Mar;71(3):435-447. doi: 10.1002/acr.23595. Epub 2019 Feb 5.
In a pilot study, our group showed that an internet-based self-management program improves self-efficacy in systemic sclerosis (SSc). The objective of the current study was to compare an internet-based self-management program to a patient-focused educational book developed to assess measures of self-efficacy and other patient-reported outcomes in patients with SSc.
We conducted a 16-week randomized, controlled trial.
Of the 267 participants who completed baseline questionnaires and were randomized to the intervention (internet: www.selfmanagescleroderma.com) or control (book) group, 123 participants (93%) in the internet group and 124 participants (94%) in the control group completed the 16-week randomized controlled trial (RCT). The mean ± SD age of all participants was 53.7 ± 11.7 years, 91% were women, and 79.4% had some college or a higher degree. The mean ± SD disease duration after diagnosis of SSc was 8.97 ± 8.50 years. There were no statistical differences between the 2 groups for the primary outcome measure (Patient-Reported Outcomes Measurement Information System Self-Efficacy for Managing Symptoms: mean change of 0.35 in the internet group versus 0.94 in the control group; P = 0.47) and secondary outcome measures, except the EuroQol 5-domain instrument visual analog scale score (P = 0.05). Internet group participants agreed that the self-management modules were of importance to them, the information was presented clearly, and the website was easy to use and at an appropriate reading level.
Our RCT showed that the internet-based self-management website was not statistically superior to an educational patient-focused book in improving self-efficacy and other measures. The participants were enthusiastic about the content and presentation of the self-management website.
在一项初步研究中,我们的团队发现,基于互联网的自我管理项目可以提高系统性硬化症(SSc)患者的自我效能感。本研究的目的是比较基于互联网的自我管理项目与专门为评估 SSc 患者自我效能感和其他患者报告结局而开发的以患者为中心的教育书籍,以评估这两种干预措施在改善自我效能感和其他患者报告结局方面的效果。
我们开展了一项为期 16 周的随机对照试验。
在完成基线问卷并随机分配到干预组(互联网:www.selfmanagescleroderma.com)或对照组(书籍)的 267 名参与者中,有 123 名(93%)互联网组和 124 名(94%)对照组参与者完成了 16 周的随机对照试验(RCT)。所有参与者的平均年龄(标准差)为 53.7±11.7 岁,91%为女性,79.4%具有大专及以上学历。SSc 确诊后平均病程(标准差)为 8.97±8.50 年。两组主要结局指标(患者报告结局测量信息系统自我管理症状效能:互联网组平均变化 0.35,对照组为 0.94;P=0.47)和次要结局指标均无统计学差异,除了欧洲五维健康量表视觉模拟评分(P=0.05)。互联网组参与者认为自我管理模块对他们很重要,信息表达清晰,网站易于使用且阅读难度适宜。
本 RCT 表明,基于互联网的自我管理网站在提高自我效能感和其他指标方面并不优于以患者为中心的教育书籍。参与者对自我管理网站的内容和呈现方式非常感兴趣。