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一项针对中年女性膝关节功能状况和健康相关生活质量的自我管理支持干预:一项随机对照试验。

A self-management support intervention on knee functional status and health-related quality of life among middle-age women: A randomized controlled trial.

机构信息

Faculty of Nursing, Walailak University, Nakhon Si Thammarat, Thailand.

Faculty of Nursing, Burapha University, Chon Buri, Thailand.

出版信息

J Adv Nurs. 2021 Jan;77(1):376-386. doi: 10.1111/jan.14600. Epub 2020 Oct 21.

Abstract

AIM

To determine the effectiveness of a self-management support intervention on knee functional status and health-related quality of life among middle-age women with knee osteoarthritis.

DESIGN

Randomized controlled trial.

METHODS

The participants were 40 middle-aged women who had been clinically diagnosed with knee osteoarthritis for more than 3 months and randomly assigned into intervention and control groups equally. After IRB approval code 02-05-2562 was obtained, data collection was carried out from July - November 2019 at the Outpatient Department of Orthorpedics, Thasala Hospital, Thailand. The modified Thai version of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Short Form Survey (SF-36) were used to measure knee functional status and health-related quality of life at baseline (T1), immediately after completing the intervention (T2) and 4 weeks after the intervention (T3). The participants in the intervention group received a self-management support program developed by the researcher based on the Individual and Family Self-Management Theory and a review of related literature plus routine care. The implementation consisted of eight sessions over 4 weeks. The control group received only routine care from the hospital. Two-way repeated measure ANOVAs were used to analyze the data.

RESULTS

The findings revealed that the participants in the intervention group had better knee functional status and HRQOL than those in the control group at follow-up. Additionally, in the intervention group, both knee functional status and HRQOL significantly improved from pre- to post-intervention and follow-up.

CONCLUSIONS

The findings indicate that this self-management support intervention is effective.

IMPACT

For women, the prevalence rate of knee OA rises dramatically post-menopause due to lower oestrogen levels. Policy makers and healthcare providers could obtain and promote this intervention as part of standard practice. This should lead to improved knee functional status and HRQOL among middle-aged women. Thai Trial Registration number: TCTR20191223003. on February 5th, 2019.

摘要

目的

确定自我管理支持干预对中年膝骨关节炎女性膝关节功能状况和健康相关生活质量的影响。

设计

随机对照试验。

方法

参与者为 40 名中年女性,临床诊断为膝骨关节炎 3 个月以上,按随机数字表法分为干预组和对照组,每组 20 名。在获得 IRB 批准号 02-05-2562 后,于 2019 年 7 月至 11 月在泰国 Thasala 医院骨科门诊进行数据收集。采用改良后的泰国版 Western Ontario and McMaster University Osteoarthritis Index(WOMAC)和 Short Form Survey(SF-36)量表在基线(T1)、干预结束时(T2)和干预结束后 4 周(T3)测量膝关节功能状况和健康相关生活质量。干预组接受研究者基于个体和家庭自我管理理论和相关文献综述开发的自我管理支持方案以及常规护理。实施包括 4 周内 8 次。对照组仅接受医院的常规护理。采用双向重复测量方差分析进行数据分析。

结果

研究结果表明,随访时干预组患者的膝关节功能状况和 HRQOL 均优于对照组。此外,干预组患者的膝关节功能状况和 HRQOL 在干预前、干预中和随访中均显著改善。

结论

研究结果表明,该自我管理支持干预是有效的。

意义

对于女性而言,由于雌激素水平降低,绝经后膝骨关节炎的患病率显著上升。政策制定者和医疗保健提供者可以将该干预措施作为标准实践的一部分进行获取和推广。这将导致中年女性的膝关节功能状况和健康相关生活质量得到改善。泰国临床试验注册号:TCTR20191223003,注册日期:2019 年 2 月 5 日。

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