Kanagaraj Puvaneswari
Department of Nursing, College of Applied Medical Sciences, University of Bisha, P.O Box- 551, Bisha, Saudi Arabia.
Int J Orthop Trauma Nurs. 2025 May;57:101178. doi: 10.1016/j.ijotn.2025.101178. Epub 2025 Apr 1.
Rheumatoid Arthritis(RA) can result in significant joint destruction and work disability which needs physical and psychosocial adjustment to deal with pain, and fatigue.
True experimental parallel arm design with a pre-test post-test wait-listed control group was used to assess the impact of self-management training on Quality of life, medication adherence and self-efficacy among patients with RA. Participants were randomly allocated to the study(70) or control(70)group by simple randomization by the researcher. The study group underwent a self-management training consisting of six sessions over a 12-week period, while the control group received routine care. Importantly, the research assistant responsible for outcome assessment remained blinded to the treatment allocation at 1st, 3rd and 5th month post intervention using Short form- 36, Compliance Questionnaire, Rheumatology and Arthritis self efficacy scale.
The SMT led to significant improvements in QoL-physical components including Pain (p = 0.001, partial eta squared(η²) = 0.372) and General Health (p = 0.001, η² = 0.320). Significant between-group differences were observed for Pain (p = 0.007), while other measures showed no differences. Mental health components also improved significantly in the study group, particularly in Energy (p = 0.001, η² = 0.344). Medication adherence improved initially but stabilized over time. The study group showed significant improvements in self-efficacy for pain, function, and other symptoms (p < 0.009), with large effect sizes and sustained progress.
By empowering patients with knowledge, skills, and confidence to effectively manage their condition, such health educations can contribute significantly improve overall health outcomes.
类风湿性关节炎（RA）可导致严重的关节破坏和工作能力丧失，这需要身体和心理社会方面的调整来应对疼痛和疲劳。
采用真实验平行组设计，设置前测后测等待列表对照组，以评估自我管理训练对类风湿性关节炎患者生活质量、药物依从性和自我效能的影响。研究人员通过简单随机化将参与者随机分配到研究组（70例）或对照组（70例）。研究组在12周内接受了为期六次的自我管理训练，而对照组接受常规护理。重要的是，负责结果评估的研究助理在干预后第1、3和5个月使用简短36项健康调查量表、依从性问卷、风湿病和关节炎自我效能量表时，对治疗分配情况保持盲态。
自我管理训练使生活质量的身体方面有显著改善，包括疼痛（p = 0.001，偏 eta 平方（η²）= 0.372）和总体健康（p = 0.001，η² = 0.320）。在疼痛方面观察到显著的组间差异（p = 0.007），而其他指标无差异。研究组的心理健康方面也有显著改善，尤其是精力方面（p = 0.001，η² = 0.344）。药物依从性最初有所改善，但随着时间推移趋于稳定。研究组在疼痛、功能和其他症状的自我效能方面有显著改善（p < 0.009），效应量较大且进展持续。
通过赋予患者知识、技能和信心以有效管理自身病情，此类健康教育可显著改善整体健康结果。
