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类风湿关节炎患者教育工具的随机对照试验。

Randomized Controlled Trial of Patient Education Tools for Patients With Rheumatoid Arthritis.

机构信息

The University of Texas, MD Anderson Cancer Center, Houston.

Houston Rheumatology & Arthritis Specialists, Memorial Hermann, Houston, Texas.

出版信息

Arthritis Care Res (Hoboken). 2021 Oct;73(10):1470-1478. doi: 10.1002/acr.24362. Epub 2021 Aug 31.

Abstract

OBJECTIVE

The present study was undertaken to evaluate the efficacy of 2 educational tools for patients with rheumatoid arthritis (RA) by comparing a newly developed video tool, including storylines and testimonials, combined with a written booklet to the same written booklet alone.

METHODS

We conducted a randomized controlled trial. Our primary outcome was disease knowledge. Secondary outcomes were decisional conflict, self-efficacy, effective health care management, and satisfaction. Outcomes were measured before and after reviewing the materials, and 3 and 6 months later. Linear mixed-effects models were performed to evaluate changes over time.

RESULTS

In total, 221 participants received an educational video and booklet (n = 111) or a booklet alone (n = 110). The mean age was 50.8 years, mean disease duration was 4.8 years, 85% were female, and 24% had limited health literacy levels. Within groups, most outcomes improved between baseline and follow-up, but there were no statistically significant differences across groups. Patients receiving the video and booklet were more likely than those receiving the booklet alone to rate the presentation as excellent for providing information about the impact of RA, medication options, evidence about medications, benefits of medication, and self-care options. Factors significantly associated with greater improvements in knowledge and decisional conflict from baseline to 6 months included limited health literacy, lower educational level, and shorter disease duration.

CONCLUSION

Regardless of the delivery method, outcomes were improved up to 6 months after educational materials were delivered. Our findings support the implementation of self-administered educational materials in clinical settings, as they can result in sustained improvements in disease knowledge and decisional conflict.

摘要

目的

本研究旨在通过比较新开发的包含故事情节和患者证言的视频工具与单纯的书面手册,评估两种类风湿关节炎(RA)患者教育工具的疗效。

方法

我们进行了一项随机对照试验。我们的主要结局指标是疾病知识。次要结局指标包括决策冲突、自我效能感、有效的医疗保健管理和满意度。在阅读材料前后以及 3 个月和 6 个月后测量这些结局。采用线性混合效应模型评估随时间的变化。

结果

共有 221 名参与者接受了教育视频和手册(n = 111)或单独的手册(n = 110)。平均年龄为 50.8 岁,平均疾病持续时间为 4.8 年,85%为女性,24%有一定的健康素养水平。组内大多数结局在基线和随访之间有所改善,但组间无统计学差异。与单独接受手册的患者相比,接受视频和手册的患者更有可能认为该视频在提供有关 RA 影响、药物选择、药物证据、药物益处和自我护理选择方面的信息方面表现出色。与从基线到 6 个月知识和决策冲突显著改善相关的因素包括健康素养有限、教育程度较低和疾病持续时间较短。

结论

无论采用何种传递方式,在提供教育材料后 6 个月内,结局都得到了改善。我们的研究结果支持在临床环境中实施自我管理的教育材料,因为它们可以持续改善疾病知识和决策冲突。

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