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一项比较两种针对膝骨关节炎患者的自我管理教育策略的随机对照试验。

A Randomized Controlled Trial Comparing Two Self-Administered Educational Strategies for Patients With Knee Osteoarthritis.

作者信息

Lopez-Olivo Maria A, des Bordes Jude K, Lin Heather, Volk Robert J, Rizvi Tara, Suarez-Almazor Maria E

机构信息

The University of Texas MD Anderson Cancer Center, Houston.

McGovern Medical School, The University of Texas Health Science Center at Houston.

出版信息

ACR Open Rheumatol. 2021 Mar;3(3):185-195. doi: 10.1002/acr2.11222. Epub 2021 Feb 16.

Abstract

OBJECTIVE

The objective of this study was to assess the efficacy of self-administered patient educational tools in improving knowledge and behaviors for the management of knee osteoarthritis.

METHODS

We conducted a randomized clinical trial in patients with knee osteoarthritis to assess the efficacy of providing a video for entertainment education, in combination with two booklets, compared with providing the booklets alone. We evaluated changes in scores on a patient knowledge questionnaire, the Decisional Conflict Scale, the Arthritis Self-Efficacy Scale, and the Effective Consumer Scale between baseline and same day, 3 months, and 6 months post intervention. We used linear regression models to explore associations between demographic characteristics and outcomes, testing for interactions.

RESULTS

Two hundred nineteen participants were randomly assigned to receive the video + booklets (n = 109) or the booklets alone (n = 110). The mean age of participants was 64.6 (±8.3) years. At 6 months, statistically significant improvements were observed in knowledge and decisional conflict scores for both groups, and statistically significant improvements in the behavior to participate in their health care were observed in the video + booklets group. The video + booklets group was more knowledgeable immediately post intervention than the booklet group (mean difference 0.39 [95% confidence interval 0.02-0.76]). No other significant changes in outcomes were observed at 6 months between the two groups. The video + booklets combination was associated with decreased decisional conflict in Spanish speakers and increased self-efficacy in those with less than a high school education.

CONCLUSION

Although both education strategies were associated with improved knowledge and reduced decisional conflict at 6 months, receiving the video + booklets in combination, compared with receiving the booklets alone, proved to be more effective in changing behaviors and appeared to have some advantages for Spanish speakers and those who were less educated.

摘要

目的

本研究的目的是评估患者自行使用的教育工具在改善膝关节骨关节炎管理的知识和行为方面的效果。

方法

我们对膝关节骨关节炎患者进行了一项随机临床试验,以评估提供用于娱乐教育的视频并结合两本小册子与仅提供小册子相比的效果。我们评估了患者知识问卷、决策冲突量表、关节炎自我效能量表和有效消费者量表在基线与干预后当天、3个月和6个月时的得分变化。我们使用线性回归模型来探索人口统计学特征与结果之间的关联,并进行交互作用检验。

结果

219名参与者被随机分配接受视频+小册子(n = 109)或仅接受小册子(n = 110)。参与者的平均年龄为64.6(±8.3)岁。在6个月时,两组的知识和决策冲突得分均有统计学显著改善,视频+小册子组在参与自身医疗保健的行为方面有统计学显著改善。视频+小册子组在干预后即刻比小册子组知识更丰富(平均差异0.39 [95%置信区间0.02 - 0.76])。两组在6个月时未观察到其他显著的结果变化。视频+小册子组合与西班牙语使用者决策冲突的减少以及高中以下学历者自我效能的提高相关。

结论

尽管两种教育策略在6个月时均与知识改善和决策冲突减少相关,但与仅接受小册子相比,接受视频+小册子组合在改变行为方面被证明更有效,并且对西班牙语使用者和受教育程度较低者似乎有一些优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d88/7966878/6b381b290938/ACR2-3-185-g001.jpg

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