Langer H E, Birth U
Abteilung Krankheiten der Bewegungsorgane und des Stoffwechsels, Medizinischen Hochschule Hannover.
Z Rheumatol. 1988 Jan-Feb;47(1):43-51.
Efficacy and possible negative side effects of a patient education program for rheumatoid arthritis were evaluated in a controlled, prospective study over 3 months. 34 outpatients were educated over a total of 8 h in three groups within a patient-centred design. Before the program the knowledge of the disease depended only on the formal grade of education but not on disease-related variables such as disease duration or disability. Probably due to its individualizing method, the program improved the knowledge of all patients to the same extent, regardless of their intellectual and social prerequisites. The increased cognitive knowledge did not result in negative side effects like increased pain or depression. The pain score remained unchanged. Depression decreased after the education. The group sessions made us suppose that the participants may have represented a selected group of active, psychologically stable patients, who cope well with rheumatoid arthritis. In contrast, we felt that non-participation was the response of the inactive, fatalistic patients with rheumatoid arthritis, who live in social isolation and especially need our care. Therefore, future efforts must particularly focus on the problem of motivation and on an increase in the rate of participation.
在一项为期3个月的对照前瞻性研究中，对一项类风湿性关节炎患者教育项目的疗效及可能的负面副作用进行了评估。在以患者为中心的设计中，将34名门诊患者分为三组，总共接受了8小时的教育。在该项目实施前，患者对疾病的了解仅取决于正规教育程度，而不取决于疾病持续时间或残疾等与疾病相关的变量。可能由于其个体化方法，该项目在相同程度上提高了所有患者的知识水平，无论他们的智力和社会条件如何。认知知识的增加并未导致疼痛加剧或抑郁等负面副作用。疼痛评分保持不变。教育后抑郁情绪有所减轻。小组讨论让我们推测，参与者可能是一群经过挑选的、积极活跃、心理稳定且能很好应对类风湿性关节炎的患者。相比之下，我们认为不参与是患有类风湿性关节炎的消极、宿命论患者的反应，他们生活在社会隔离中，尤其需要我们的关怀。因此，未来的努力必须特别关注动机问题以及提高参与率。
