Åkesson Karin Sturesdotter, Sundén Anne, Stigmar Kjerstin, Eek Frida, Pawlikowska Teresa, Hansson Eva Ekvall
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Arch Physiother. 2023 Sep 22;13(1):18. doi: 10.1186/s40945-023-00172-7.
Osteoarthritis is a leading cause of disability worldwide. Current treatment supports coping strategies to improve health-related quality of life (HRQoL). The need to predict response to treatment has been raised to personalise care. This study aims to examine change in HRQoL from baseline to three and nine months follow-up after participating in a Supported Osteoarthritis Self-Management Programme (SOASP) and to examine if empowerment and/or enablement were associated with change in HRQoL after a SOASP.
Patients participating in a SOASP were recruited consecutively between April 2016 and June 2018. The EQ-5D was used to measure HRQoL, the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23) (score range 1-5) to measure empowerment and the Patient Enablement Instrument (PEI) (score range 0-12) to measure enablement. The instruments were answered before (EQ-5D, SWE-RES-23) and after (EQ-5D, SWE-RES-23, PEI) the SOASP. A patient partner was involved in the research process to enhance the patient perspective. Changes in outcome were examined with paired sample t-test and standardized effect sizes (Cohen´s d). Multiple linear regression analysis was performed to assess potential associations.
One hundred forty-three patients participated in baseline measurement. Mean EQ-5D-5 L index score increased significantly from baseline to three months corresponding to a standardised effect size (Cohen´s d) of d = 0.43, 95% CI [0.24, 0.63] (n = 109), and from baseline to nine months d = 0.19, 95% CI [0.01, 0.37] (n = 119). The average EQ VAS score increased significantly from baseline to three months corresponding to a standardised effect size of d = 0.26, 95% CI [0.07, 0.45] (n = 109), and from baseline to nine months d = 0.18, 95% CI [0.00, 0.36] (n = 119). Neither SWE-RES-23 nor PEI at three months follow-up nor the change in the SWE-RES-23 score from baseline to three months follow-up were associated with change in either EQ-5D-5 L index (p > 0.05) or the EQ VAS (p > 0.05).
Health-related quality of life increased after participating in a SOASP. Empowerment and enablement as measured with the SWE-RES-23 and the PEI were not associated with change in HRQoL among patients participating in a SOASP.
ClinicalTrials.gov. Identification number: NCT02974036. First registration 28/11/2016, retrospectively registered.
骨关节炎是全球致残的主要原因。目前的治疗支持应对策略，以改善健康相关生活质量（HRQoL）。为实现个性化护理，人们提出了预测治疗反应的需求。本研究旨在探讨参与支持性骨关节炎自我管理计划（SOASP）后，从基线到三个月及九个月随访期间HRQoL的变化，并研究赋权和/或赋能是否与参与SOASP后的HRQoL变化相关。
2016年4月至2018年6月期间连续招募参与SOASP的患者。使用EQ-5D测量HRQoL，使用瑞典风湿病赋权量表（SWE-RES-23）（评分范围1-5）测量赋权，使用患者赋能工具（PEI）（评分范围0-12）测量赋能。这些工具在SOASP之前（EQ-5D、SWE-RES-23）和之后（EQ-5D、SWE-RES-23、PEI）进行填写。研究过程中有患者伙伴参与，以增强患者视角。使用配对样本t检验和标准化效应量（科恩d值）检查结果变化。进行多元线性回归分析以评估潜在关联。
143名患者参与了基线测量。EQ-5D-5L指数平均得分从基线到三个月显著增加，标准化效应量（科恩d值）为d = 0.43，95%CI [0.24, 0.63]（n = 109），从基线到九个月d = 0.19，95%CI [0.01, 0.37]（n = 119）。EQ VAS平均得分从基线到三个月显著增加，标准化效应量为d = 0.26，95%CI [0.07, 0.45]（n = 109），从基线到九个月d = 0.18，95%CI [0.00, 0.36]（n = 119）。三个月随访时的SWE-RES-23和PEI，以及从基线到三个月随访期间SWE-RES-23评分的变化，均与EQ-5D-5L指数（p > 0.05）或EQ VAS（p > 0.05）的变化无关。
参与SOASP后，健康相关生活质量有所提高。用SWE-RES-23和PEI测量的赋权和赋能与参与SOASP的患者的HRQoL变化无关。
ClinicalTrials.gov。识别号：NCT02974036。首次注册于2016年11月28日，追溯注册。
