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Long‐term effects of a nurse‐led group and individual patient education programme for patients with chronic inflammatory polyarthritis – a randomised controlled trial
Author(s) -
Grønning Kjersti,
Rannestad Toril,
Skomsvoll Johan F,
Rygg Lisbeth Ø,
Steinsbekk Aslak
Publication year - 2014
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.12353
Subject(s) - medicine , rheumatoid arthritis , polyarthritis , physical therapy , arthritis , randomized controlled trial , psoriatic arthritis , psychological intervention , nursing
Aims and objectives To investigate the long‐term effect of a nurse‐led hospital‐based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background Patient education interventions have shown short‐term effects, but few studies have investigated whether the effects are sustained for a longer period. Design Randomised controlled trial. Methods Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group ( n = 71) or a waiting list ( n = 70). Primary outcomes were as follows: Global Well‐Being and the Arthritis Self‐Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a D isease Activity S core ( DAS 28‐3). Results The intervention group had a statistically significant higher global well‐being than the controls after 12 months, mean change score 8·2 (95% CI , 1·6–14·8; p ‐value = 0·015), but not in the Arthritis Self‐Efficacy Other Symptoms Subscale, mean change score 2·6 (95% CI , −1·8 to 7·1; p ‐value = 0·245). Within each group, analyses showed a statistically significant improvement in DAS 28‐3, mean change ‐0·3 (95% CI , −0·5 to −0·1; p ‐value = 0·001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis Self‐Efficacy Other Symptoms Subscale, mean change −5·0 (95% CI , −8·6 to −1·3; p ‐value = 0·008), A rthritis I mpact M easurement S cales – 2 Social, mean change 0·3 (95% CI , 0·1–0·5; p ‐value = 0·008), and H ospital A nxiety and D epression S cale total, mean change 1·4 (95% CI , 0·3–2·5; p ‐value = 0·013). Conclusion A combination of group and individual patient education has a long‐term effect on patients' global well‐being. Relevance to clinical practice Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less time‐consuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.