Gerlich C, Andreica I, Küffner R, Krause D, Lakomek H J, Reusch A, Braun J
Arbeitsbereich Medizinische Psychologie und Psychotherapie im Zentrum für psychische Gesundheit (ZEP), Universität Würzburg, Klinikstr. 3, 97070, Würzburg, Deutschland.
Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Deutschland.
Z Rheumatol. 2020 Oct;79(8):737-748. doi: 10.1007/s00393-020-00769-4.
A new conceptual framework has enabled the flexible development of rheumatological patient educational programs for different healthcare settings. On this basis, a 5‑h basic training program for patients with rheumatoid arthritis (RA) was developed to be used in specialized centers. Rheumatologists and psychologists were first trained and then the efficacy of the patient training program was evaluated based on the causal model of patient education.
The externally randomized waiting control group study with 249 RA patients included 3 measurement points. The impact of the 5‑h basic training on disease and treatment-related knowledge as well as health competence of RA patients was examined. Secondary questions included attitudinal parameters, communication competence, effects on the disease and satisfaction with the educational program. Data were analyzed on an intention to treat basis by means of covariance analyses for the main target variables, adjusted for baseline values.
The analyses showed that the training program was effective. Even 3 months after training, participants reported more knowledge and health competence than the waiting control group, with small to medium-sized effects (d = 0.37 and 0.38, respectively). With the exception of disease communication, no other effects of training were observed in the secondary objectives.
The basic training program provides a good foundation to develop further interventions to improve attitudinal and disease parameters. It can serve as a central component for rheumatological healthcare for patients with RA at various levels.
一个新的概念框架使得能够针对不同医疗环境灵活开发风湿病患者教育项目。在此基础上，开发了一个针对类风湿关节炎（RA）患者的5小时基础培训项目，用于专科中心。首先对风湿病学家和心理学家进行培训，然后基于患者教育的因果模型评估患者培训项目的效果。
这项针对249例RA患者的外部随机等待对照组研究包括3个测量点。考察了5小时基础培训对RA患者疾病及治疗相关知识以及健康能力的影响。次要问题包括态度参数、沟通能力、对疾病的影响以及对教育项目的满意度。通过对主要目标变量进行协方差分析，并对基线值进行调整，以意向性分析为基础对数据进行分析。
分析表明培训项目是有效的。即使在培训3个月后，参与者报告的知识和健康能力也比等待对照组更多，效果为小到中等（效应量分别为d = 0.37和0.38）。在次要目标中，除了疾病沟通外，未观察到培训的其他效果。
基础培训项目为进一步开发改善态度和疾病参数的干预措施提供了良好基础。它可以作为各级RA患者风湿病医疗保健的核心组成部分。
