Effects of Self-Management Intervention Programs Based on the Health Belief Model and Planned Behavior Theory on Self-Management Behavior and Quality of Life in Middle-Aged Stroke Patients

Objectives. To study the effect of self-management intervention programs based on the health belief model and planned behavior theory on self-management behavior and quality of life in middle-aged stroke patients. Most of the intervention studies on the self-management of middle-aged stroke patients focus on traditional Chinese medicine nursing and continuous nursing, lacking theoretical support. In particular, there is a lack of interventions based on the integration of two or more theories. Method. The middle-aged stroke patients were divided into the control group and the intervention group according to the disease area. A total of 70 patients were included, and 35 patients were included in the control group and the intervention group, respectively. The control group received routine neurological treatment and health education during hospitalization and continued to receive routine health education for 3 months after discharge. On this basis, the intervention group received an intervention program based on an integrated model of health beliefs and planned behavior theory, including 3 health education sessions during hospitalization and 3 months of postdischarge health education. A self-administered stroke general information questionnaire was used to collect basic information on patients’ age, gender, and comorbidities. The Stroke Self-Management Behavior Rating Scale and Stroke-Specific Quality-of-Life Scale (SS-QOL) were used to evaluate the management behavior and quality of life of the patients in both groups before and after the intervention. Results. Before the intervention, there was no statistically significant difference between the two groups in terms of self-management score, quality of life total score, and scores of each dimension P > 0.05 . At different periods after the intervention, the total score of self-management, total score of quality of life, and scores of each dimension were significantly higher in both groups than before the intervention P < 0.05 . In particular, the self-management and quality of life scores of the intervention group were higher than those of the control group at 1 and 3 months after the intervention P < 0.05 . Conclusion. The self-management intervention scheme based on the integrated model of health belief and planned behavior theory is beneficial to improve the self-management ability and quality of life of stroke patients. It provides basis for clinical nurses to further improve the self-management ability and quality of life of stroke patients. Our findings may also serve as a reference for caregivers in other countries to improve the self-management and quality of life of stroke patients.

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Health Education Through a Campaign and mHealth to Enhance Knowledge and Quality of Life Among Patients With Chronic Kidney Disease in Bangladesh: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.30191 ◽

2021 ◽

Author(s):

Mohammad Habibur Rahman Sarker ◽

Michiko Moriyama ◽

Harun Ur Rashid ◽

Md Moshiur Rahman ◽

Mohammod Jobayer Chisti ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Randomized Controlled Trial ◽

Kidney Disease ◽

Health Education ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled

BACKGROUND Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. OBJECTIVE The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. METHODS A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. RESULTS Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. CONCLUSIONS It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/30191

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Mobile Health App With Social Media to Support Self-Management for Patients With Chronic Kidney Disease: Prospective Randomized Controlled Study (Preprint)

10.2196/preprints.19452 ◽

2020 ◽

Author(s):

Wen-Yi Li ◽

Fu-Chun Chiu ◽

Jyun-Kai Zeng ◽

Yao-Wei Li ◽

Su-Hua Huang ◽

...

Keyword(s):

Quality Of Life ◽

Social Media ◽

Kidney Disease ◽

Health Management ◽

Intervention Group ◽

Wearable Devices ◽

Self Management ◽

Control Group ◽

Management Platform

BACKGROUND Chronic kidney disease (CKD) is a global health burden. Self-management plays a key role in improving modifiable risk factors. OBJECTIVE The aim of this study was to evaluate the effectiveness of wearable devices, a health management platform, and social media at improving the self-management of CKD, with the goal of establishing a new self-management intervention model. METHODS In a 90-day prospective experimental study, a total of 60 people with CKD at stages 1-4 were enrolled in the intervention group (n=30) and control group (n=30). All participants were provided with wearable devices that collected exercise-related data. All participants maintained dietary diaries using a smartphone app. All dietary and exercise information was then uploaded to a health management platform. Suggestions about diet and exercise were provided to the intervention group only, and a social media group was created to inspire the participants in the intervention group. Participants’ self-efficacy and self-management questionnaire scores, Kidney Disease Quality of Life scores, body composition, and laboratory examinations before and after the intervention were compared between the intervention and control groups. RESULTS A total of 49 participants completed the study (25 in the intervention group and 24 in the control group); 74% of the participants were men and the mean age was 51.22 years. There were no differences in measured baseline characteristics between the groups except for educational background. After the intervention, the intervention group showed significantly higher scores for self-efficacy (mean 171.28, SD 22.92 vs mean 142.21, SD 26.36; P<.001) and self-management (mean 54.16, SD 6.71 vs mean 47.58, SD 6.42; P=.001). Kidney Disease Quality of Life scores were also higher in the intervention group (mean 293.16, SD 34.21 vs mean 276.37, SD 32.21; P=.02). The number of steps per day increased in the intervention group (9768.56 in week 1 and 11,389.12 in week 12). The estimated glomerular filtration rate (eGFR) of the intervention group was higher than that of the control group (mean 72.47, SD 24.28 vs mean 59.69, SD 22.25 mL/min/1.73m2; P=.03) and the decline in eGFR was significantly slower in the intervention group (–0.56 vs –4.58 mL/min/1.73m2). There were no differences in body composition between groups postintervention. CONCLUSIONS The use of wearable devices, a health management platform, and social media support not only strengthened self-efficacy and self-management but also improved quality of life and a slower eGFR decline in people with CKD at stages 1-4. These results outline a new self-management model to promote healthy lifestyle behaviors for patients with CKD. CLINICALTRIAL ClinicalTrials.gov NCT04617431; https://www.clinicaltrials.gov/ct2/show/NCT04617431

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Health Education Through a Campaign and mHealth to Enhance Knowledge and Quality of Life Among Patients With Chronic Kidney Disease in Bangladesh: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/30191 ◽

2021 ◽

Vol 10 (11) ◽

pp. e30191

Author(s):

Mohammad Habibur Rahman Sarker ◽

Michiko Moriyama ◽

Harun Ur Rashid ◽

Md Moshiur Rahman ◽

Mohammod Jobayer Chisti ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Randomized Controlled Trial ◽

Kidney Disease ◽

Health Education ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Randomized Controlled

Background Despite the growing burden of chronic kidney disease (CKD), disease knowledge and understanding are still lacking, especially in Bangladesh. Objective The aim of this study was to evaluate the outcome of a health education intervention in order to enhance knowledge, health-related quality of life (QOL), and motivation regarding healthy lifestyles among rural and periurban adults suffering from CKD. Methods A parallel-group (1:1) randomized controlled trial is ongoing in the Mirzapur subdistrict, Bangladesh, where two groups of patients with CKD are being compared. Patients aged 18 years and over with CKD (stages 1-3) were enrolled in November 2020. Patients were randomly allocated into either the intervention group (n=63) or the control group (n=63). The control group received usual treatment, while the intervention group received health education through a CKD campaign facilitated by a nephrologist and via mHealth (ie, periodic mobile phone calls) from community health workers. Both groups were followed up for a period of 6 months. The primary endpoint is patients’ increased knowledge measured using the Chronic Kidney Disease Knowledge Questionnaire. The secondary endpoints are improved QOL measured using the standardized EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire as well as improvements in the levels of blood pressure, BMI, serum creatinine, fasting blood sugar, hemoglobin, cholesterol, high-density lipoprotein cholesterol, triglyceride, serum uric acid, blood urea nitrogen, and albumin to creatinine ratio. Results Enrollment of participants began in November 2020; the intervention and follow-up were completed in May 2021. We enrolled 126 patients in the study. Patients’ mean ages were 57.97 (SD 15.03) years in the control group and 57.32 (SD 14.37) years in the intervention group. There were 45 out of 63 (71%) females in the control group and 38 out of 63 (60%) females in the intervention group. In addition, there were 38 out of 63 (60%) literate patients in the control group and 33 out of 63 (52%) literate patients in the intervention group. Conclusions It is expected that a combined approach, incorporating both a CKD campaign and mHealth, for health education may be an effective tool for increasing knowledge and improving QOL among patients with CKD. Trial Registration ClinicalTrials.gov NCT04094831; https://clinicaltrials.gov/ct2/show/NCT04094831 International Registered Report Identifier (IRRID) DERR1-10.2196/30191

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Effectiveness of Health Promotional Strategies on Quality of Life among Spouse of Alcoholics in Selected Communities of Dakshina Kannada District, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44648.14038 ◽

2020 ◽

Author(s):

PJ Shiji ◽

Neetha Kamath ◽

Supriya Hegde

Keyword(s):

Quality Of Life ◽

Health Education ◽

Demographic Variable ◽

Intervention Group ◽

Control Group ◽

The Family ◽

Post Test ◽

Promotional Strategies ◽

And Control

Introduction: Alcoholism is a major problem in developing countries like India. Alcoholism affects not only the individual but also his family and the society. Spouses of alcoholics are among those who suffer the maximum consequences of alcoholism and its effects. Aim: To find the effect of health promotional strategies (Yoga and Health education) on Quality of Life (QOL) of the spouse of alcoholics. Materials and Methods: Quasi experimental pre-test post-test control design was adopted. A total of 330 men were administered the Alcohol Use Disorders Identification Test (AUDIT) tool to screen for alcoholics through house to house survey, of which 279 men who scored in the range of 8-15 AUDIT score were considered as alcoholics. Their spouses were selected as study participants (who met the sampling criteria) and subjects were randomly allocated to intervention group (132) and control group (147) through simple randomised sampling. The data was gathered by using WHOQOL-BREF tool to assess the QOL; initially pre-test QOL was assessed, followed by individual health education (45 minutes) and yoga (15 minutes) once a week for 3 consecutive weeks and post-test was done during fourth week for intervention (127) and control groups (142). There were five dropouts in post-test from each group due to health problems, migration and no cooperation from the family for the intervention. Independent t-test was performed by using SPSS version 18.0 to determine effectiveness of health promotion strategies on QOL scores between the intervention and control group and chi-square test was used to find the association between post-intervention QOL scores and selected demographic variable at p<0.05 level of significance. Results: QOL scores in all four domains in the intervention group showed that there was an increase before and after the interventions. On comparing the mean differences between QOL scores post-test in intervention and control group, calculated t-value was (34.04) and the difference was highly statistically significant at p<0.001** showing that health promotional strategies were effective in improving QOL among spouse of alcoholics. There was a significant association between post-test intervention QOL scores of subjects and selected variables such as primary decision maker (p=0.002*) of the family and history of domestic violence (p=0.030*). Conclusion: The study findings suggest that adopting health promotional strategies such as yoga can help the spouses of alcoholics to improve their QOL.

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Abstract 59: The Efficacy of a Patient-Centered Self-Management Empowerment Intervention Program for First-Time Stroke Survivors: A Longitudinal Study

Stroke ◽

10.1161/str.51.suppl_1.59 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Lu Chen ◽

Xiaofang Shen ◽

Fang Wang ◽

Lin Lv ◽

Yan Chen

Keyword(s):

Quality Of Life ◽

Intervention Program ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Stroke Survivors ◽

Patient Centered ◽

First Time ◽

Management Behaviors

Keywords: Patient-centered; Self-management; Empowerment; Stroke Purpose: To evaluate the efficacy of a patient-centered self-management empowerment intervention (PCSMEI) program for first-time stroke survivors on self-management behaviors, stroke related depression and quality of life. Methods: One hundred and forty-four first-time stroke survivors were recruited from a comprehensive hospital in China. Patients were randomly allocated into control group (CG: n=72) and intervention group (IG: n=72) after baseline measurement. The intervention group received patient-centered self-management empowerment intervention (PCSMEI) and the control group received a routine care. The data of self-management behaviors, stroke related depression and quality of life were collected at baseline (T0), on discharge (T1), one month post-discharge (T2) and three months post-discharge (T3). Descriptive and Generalized Estimating Equations Modelling (GEE) analyses were conducted to estimate the intervention effect over time. Findings: One hundred and twenty-six participants finished the study (IG: n=64; CG: n=62). Significant improvement in self-management behaviors in the intervention group were observed in stretching or strengthening at T2 and T3; cognitive symptom management at T1, T2 and T3. The depression level was lower in IG than that in CG at T1, T2 and T3. Significant difference in quality of life between the two groups were shown in Physical Component Summary (PCS) at T3 and in Mental Component Summary (MCS) at T2 and T3. Conclusions: The patient-centered self-management empowerment intervention program appears to be an effective and well-received solution to improve first-time stroke patients’ self-management behaviors, stroke related depression and quality of life. Clinical Relevance: This program may be effective for first-time stroke patients.

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Impact of Health Education program on health related quality of life among patients with End Stage Renal Disease on hemodialysis and their Caregivers at Ain Shams University Hospital

QJM ◽

10.1093/qjmed/hcaa045.006 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

A M Ibrahim ◽

A E Shoman ◽

G E Mady ◽

A M Hassan ◽

D H Mohamed

Keyword(s):

Quality Of Life ◽

Health Education ◽

Education Program ◽

Intervention Group ◽

University Hospital ◽

Control Group ◽

Health Education Program ◽

Stage Renal Disease ◽

End Stage

Abstract Background Patients with renal failure had poorer quality of life than patients with other chronic diseases such as heart failure, diabetes mellitus and even cancer which makes them more susceptible to withdraw dialysis treatment. Objectives The study was conducted to implement a health education program for patients with end stage renal disease on hemodialysis and their caregivers at Ain Shams University Hospital and measure its effect on their quality of life. Methods A controlled interventional study was carried out on three phases. A sample of 56 patients on chronic regular hemodialysis and their caregivers (HD) were selected from the two hemodialysis units at Ain Shams university hospital and data were collected at the beginning and after six months of the health education program. Results The intervention group of the patients after the intervention reported significant better quality of life scores than the control group in all the domains except in work status, quality of social interaction, sexual function, social support and patient satisfaction and there were statistically significant increases in the intervention group of the caregivers than the control group in social function, emotional well-being, role emotional and mental component summary scores. Conclusion The health education and individualized nutritional program had a positive effect on many components of quality of life of the hemodialysis patients and their caregivers

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A mobile health application to support self-management in patients with chronic obstructive pulmonary disease: a randomised controlled trial

Clinical Rehabilitation ◽

10.1177/0269215520946931 ◽

2020 ◽

pp. 026921552094693

Author(s):

LianHong Wang ◽

YunMei Guo ◽

Meili Wang ◽

Yan Zhao

Keyword(s):

Quality Of Life ◽

Mobile Health ◽

Intervention Group ◽

Smartphone Application ◽

Self Management ◽

Control Group ◽

Chronic Obstructive ◽

Copd Assessment Test ◽

Management Behaviour

Objective: To investigate the effects of a mobile health smartphone application to support self-management programmes on quality of life, self-management behaviour and exercise and smoking cessation behaviour in patients with chronic obstructive pulmonary disease (COPD). Design: A randomised controlled, single-blind trial, was carried out from November 2017 to February 2019, which included 78 participants admitted with COPD to the Affiliated Hospital of Zunyi Medical University in Guizhou. The study participants were randomised into intervention ( n = 39) and control groups ( n = 39). Methods: Participants in the intervention group undertook a mobile medical application-based programme in addition to routine care, and participants in the control group received only routine care. The outcome measures were health-related quality of life evaluated by the COPD Assessment-Test, self-management behaviour using the COPD Self-Management Scale and physical activity and smoking behaviour were measured using a self-designed questionnaire. Data collection was conducted at baseline, third month, sixth month and 12th months. Results: Thirty-five participants in the intervention group and 33 in the control group completed the study. Compared to the control group, participants in the intervention group showed statistically significant improvement in the COPD -Assessment -Test scores ( P < 0.01) and in all domains of the COPD Self-Management Scale scores ( P < 0.01) at 12th 12 months. Improvements in the COPD -Assessment -Test scores by 4.3 and 0.3 units, and in the total scores of the COPD Self-Management Scale total score by 23.01 and 2.28 units, respectively, were observed in the intervention and control groups, respectively over the 12-month study period. Meanwhile, the mobile health application programme also improved participants’ exercise and smoking cessation behaviour. Conclusions: The mobile health smartphone application to support self-management programmes was effective in improving health-related quality of life and self-management behaviour in patients with COPD. Trial registration: This study was registered in Chinese clinicaltrials.gov

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Pengaruh Pendidikan Kesehatan tentang Menopause terhadap Perubahan Kualitas Hidup Perempuan Klimakterik

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v4i2.242 ◽

1970 ◽

Vol 4 (2) ◽

Author(s):

Yanita Trisetiyaningsih ◽

Elsi Dwi Hapsari ◽

Shofwal Widad

Keyword(s):

Quality Of Life ◽

Health Education ◽

Intervention Group ◽

Signs And Symptoms ◽

T Test ◽

Control Group ◽

Control Group Design ◽

Significant Difference ◽

Paired T Test

Perubahan fisik dan psikologis yang terjadi pada masa klimakterium akan mempengaruhi kualitas hidup perempuan. Untuk itu diperlukan proses adaptasi terhadap berbagai masalah dan perubahan selama masa klimakterium sehingga akan meningkatkan kualitas hidup perempuan klimakterik. Kurangnya pengetahuan dan akses informasi merupakan tantangan besar yang dihadapi oleh wanita menopause. Salah satu upaya yang bisa dilakukan untuk meningkatkan pengetahuan adalah melalui pemberian pendidikan kesehatan. Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan kesehatan tentang menopause terhadap perubahan kualitas hidup perempuan klimakterik. Penelitian ini merupakan penelitian quasy experimentdengan rancangan pretest and posttest nonequivalent control group design. Penelitian dilakukan di Dusun Gamping Kidul Ambarketawang bulan Desember 2013-April 2014. Jumlah populasi sebanyak 271 orang. Sampel terdiri dari 44 orang kelompok intervensi dan 44 orang kelompok kontrol. Kelompok intervensi diberikan pendidikan kesehatan sebanyak 4 kali ceramah dan diskusi kelompok kecil, serta 1 kali praktik relaksasi dan senam yoga. Kelompok kontrol diberikan booklet tentang perubahan masa menopause, tanda dan gejala, nutrisi masa menopause, dan penatalaksanaan menopause. Instrumen yang digunakan adalah WHOQOL-BREF. Analisis yang digunakan adalah uji Paired t-test, Independent Samples t-Testdengan α 0.05.Nilai rata-rata kualitas hidup pretest pada kelompok intervensi sebesar 51,9 dan posttest sebesar 66,5. Hasil uji paired t-test menunjukkan ada perbedaan skor kualitas hidup sebelum dan sesudah diberikan pendidikan kesehatan pada kelompok intervensi (t =14,436, p=0,001). Namun tidak bermakna pada kelompok kontrol (t=1,059, p= 0,0295) dengan perubahan skor kualitas. Berdasarkan hasil penelitian dapat disimpulkan bahwa program pendidikan kesehatan tentang menopause dapat meningkatkan kualitas hidup perempuan selama periode klimakterium.Kata kunci: Klimakterium, kualitas hidup, menopause, pendidikan kesehatan.Influence of Health Education about Menopause towards the Quality of Life Changes in Climacteric Women AbstractPhysical and psychological changes that happen at the climacterium period would influence the quality of life in climacteric women. Therefore, the adaptation process is needed to overcome problems and changes during this period so that the quality of life of climacteric women could be increased. Lack of knowledge and access to information are major challenger that were faced by menopause women. One of efforts that can be done to improve their knowledge is through health education. This study aimed to identify the influence of health education about menopause towards the quality of live changes in climacteric women. The study used quasi experiment design with pretest and posttest nonequivalent control group. The location of this study was in Gamping Kidul Ambarketawang Village in December 2013 to April 2014. The total population is 271 people. Sample consisted of 44 people in the intervention group and 44 people in the control group. The intervention group received 4 times health education and small group discussion, as well as once relaxation and Yoga. Participants in control group received a booklet about menopause, signs and symptoms, nutrition during menopause period, and management of menopause. The quality of life was measured using WHOQOL-BREF. Analysis used paired t-test, independent samples t-test with α = 0.05. The mean scores of quality of life for intervention group were 51.0 (pretest) and 66.5 (posttest). The paired t-test showed that there was a significant difference of quality of life score before and after health education in the intervention group (t =14,436, p=0,001). However, there was no significant difference of quality of life in the control group (t=1,059, p= 0,0295). Based on this results, it can be concluded that health education program about menopause can increase quality of life of climacteric women. Keywords: Climacterium, health education, menopause quality of life.

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The Effect of Diabetes Self-Management Education (DSME) on Improving Self-Management and Quality of Life in Millitus Type 2 Diabetes

JOURNAL FOR QUALITY IN PUBLIC HEALTH ◽

10.30994/jqph.v4i2.176 ◽

2021 ◽

Vol 4 (2) ◽

pp. 31-37

Author(s):

Reza Diko Utama ◽

Indasah Indasah ◽

Siti Farida Noor Layla

Keyword(s):

Quality Of Life ◽

Type Ii Diabetes ◽

Management Education ◽

Self Regulation ◽

Intervention Group ◽

Self Management ◽

Control Group ◽

Type Ii ◽

Not Given

Self-management is a form of self-regulation. The purpose of this study was to determine the effect of Diabetes Self-Management Education (DSME) on the Improvement of Self-Management and Quality of Life in Type II Diabetes Millitus Patients. This research method is True-Experiment Pre-Test and Post-Test design. DSMQ and WHOQOL instruments. Independent Variable (DSME) Dependent variable Self-management and quality of life. The subjects of the control group were 55 people and the intervention group was 55 people. Wilcoxon data analysis, Maan-Whitney and Path Analysis. The results of the comparison of self-management between the intervention group and the control group, a significance value of 0.000 less than 0.05 (p <0.05), indicating that the group given effective intervention significantly improved self-management compared to the group that was not given the intervention. The results of the comparison of the quality of life of the intervention group and the control group, the significance value of 0.000 less than 0.05 (p <0.05) indicates that the group given the intervention was more effective in improving the quality of life significantly than the group that was not given the intervention. There is an effect of Diabetes Self-Management Education (DSME) on the Improvement of Self-Management and Quality of Life for Type II Diabetes Millitus Patients in the Work Area of the Kempo Health Center, Kempo District. DSME is a process to facilitate knowledge, skills and abilities in self-care (Self-Management) and quality of life

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Challenges in Evaluating an Arthritis Self-management Program for People with Hip and Knee Osteoarthritis in Real-world Clinical Settings

The Journal of Rheumatology ◽

10.3899/jrheum.111358 ◽

2012 ◽

Vol 39 (5) ◽

pp. 1047-1055 ◽

Cited By ~ 22

Author(s):

ILANA N. ACKERMAN ◽

RACHELLE BUCHBINDER ◽

RICHARD H. OSBORNE

Keyword(s):

Quality Of Life ◽

Knee Osteoarthritis ◽

Real World ◽

Intervention Group ◽

Management Program ◽

Mean Difference ◽

Self Management ◽

Control Group ◽

Clinical Settings

Objective.To evaluate the influence of a 6-week Arthritis Self-Management Program (ASMP) on health-related quality of life (HRQOL) and self-management skills in clinical settings.Methods.Individuals with hip or knee osteoarthritis referred to orthopedic surgeons or rheumatologists at 6 hospitals in Victoria, Australia, were recruited. In a randomized controlled trial, participants received the Stanford ASMP and self-help book (intervention) or book only (control). Assessments included the Assessment of Quality of Life instrument (AQoL; range −0.04 to 1.00) and Health Education Impact Questionnaire (heiQ; range 1–6) at baseline and up to 12 months. The primary outcome was HRQOL at 12 months (assessed using the AQoL).Results.Recruitment was concluded early due to persistent challenges including infrequent referrals and patient inability or disinterest in participating. Of 1125 individuals screened, only 120 were randomized (control, n = 62; intervention, n = 58). Seven ASMP were conducted while 18 scheduled ASMP were cancelled. Forty-four of 58 intervention group participants received the intervention as allocated (76%); all control group participants were sent the book (100%). Ninety-four participants (78%) completed 12-month assessments (control, 90%; intervention, 66%). There was no difference in HRQOL at 12 months (adjusted mean difference −0.02, 95% CI −0.09 to 0.05). At 6 weeks, the intervention group reported higher heiQ skill and technique acquisition scores (adjusted mean difference 0.29, 95% CI 0.04 to 0.55); however, this dissipated by 3 months.Conclusion.Significant challenges hampered this evaluation of the ASMP. The observed lack of enthusiasm from potential referrers and patients raises doubts about the practicality of this intervention in real-world settings. (ANZCTR Clinical Trials Registry no. ACTRN12606000174583)

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