Jung-Hua Shao, PhD, RN, Assistant Professor, School of Nursing, College of Medicine, Chang Gung University, Guishan District, Taoyuan City, Taiwan; and Assistant Research Fellow, Chang Gung Memorial Hospital, Linkou, Taiwan. Kuang-Hui Yu, PhD, Associate Professor, Chang Gung Memorial Hospital, Linkou, Taiwan. Su-Hui Chen, PhD, RN, Professor, School of Nursing, Chang Gung University of Science and Technology, Guishan District, Taoyuan City, Taiwan; and Research Fellow, Chang Gung Memorial Hospital, Linkou, Taiwan.
Orthop Nurs. 2020 Jul/Aug;39(4):238-245. doi: 10.1097/NOR.0000000000000676.
Joint activity and protection are key components in the management of rheumatoid arthritis (RA). Despite a shift from care in health settings to empowering patients to play an active role in the day-to-day management of their own chronic conditions, there is little evidence on RA self-management, especially for Chinese patients.
This pilot study sought to determine the feasibility and acceptability of a self-management program for patients with RA in Taiwan.
Participants were recruited at a medical center in northern Taiwan. The intervention group participated in a 6-week self-management program; the control group received standard rheumatology care. Both groups underwent baseline assessments before the intervention and at 12 weeks.
A total of 32 participants were recruited: 15 in the intervention group and 17 in the control group. Patients in the intervention group found the self-management protocol beneficial to their joint protection and activity behaviors and reported higher motivation to perform RA self-management. The posttest score for joint protection and activity self-management behavior were significantly greater for the intervention group than for the control group (p = .02).
Participants in the intervention group were highly satisfied with home visits (which included peer story-telling and goal setting) and telephone calls to support their daily home-based joint protection and self-management activities (which included self-monitoring and self-evaluation). To mitigate the fear of scammers, researchers should begin by building a trust relationship with participants.
关节活动度和保护是类风湿关节炎(RA)管理的关键组成部分。尽管医疗保健模式已从以医护人员为中心转变为以患者为中心,鼓励患者积极参与自身慢性病的日常管理,但针对 RA 自我管理的证据有限,尤其是针对中国患者。
本试点研究旨在确定台湾地区 RA 患者自我管理计划的可行性和可接受性。
参与者在台湾北部的一家医疗中心招募。干预组参加了为期 6 周的自我管理计划;对照组接受标准的风湿病护理。两组均在干预前和 12 周时进行基线评估。
共招募了 32 名参与者:干预组 15 名,对照组 17 名。干预组患者认为自我管理方案有助于保护关节和开展活动,报告的 RA 自我管理动机更高。干预组的关节保护和活动自我管理行为的后测评分明显高于对照组(p =.02)。
干预组的参与者对家访(包括同伴讲故事和设定目标)和电话支持他们的日常家庭关节保护和自我管理活动(包括自我监测和自我评估)非常满意。为了减轻对骗子的恐惧,研究人员应该首先与参与者建立信任关系。