scholarly journals Randomised controlled trial of the effects of a self-management patient education program on overall quality of life and knee pain of older people with mild to moderate knee(s) osteoarthritis

2017 ◽  
Vol 4 (2) ◽  
pp. 80
Author(s):  
Alhadi M. Jahan

<p class="abstract"><strong>Background:</strong> Knee osteoarthritis (OA) is the most important chronic rheumatic disease affecting human beings. It is more common among the older population. The objective of OA treatment is to control the symptoms, such as pain, mobility problems and consequently, to improve overall quality of life. Although, self-management patient education programs, such as educational workshops and other learning activities are effective approaches in some chronic diseases, the evidence for arthritis is still inconclusive. The aim of this trial is to compare the effectiveness of an OA of the knee self-management education program with a control group, as determined by improvements in pain and quality of life<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> In this study, we will perform a two-group, randomized (1:1 ratio), controlled study with repeated-measures to examine the differences between the two groups over time. The research sample will be selected from the patients who are referred to a physiotherapy department with a diagnosed mild to moderate knee(s) OA, aging from 45 to 65 years<span lang="EN-IN">.</span></p><p class="abstract"><strong>Conclusions:</strong> Positive findings of this trial will pave the road for new methods of cooperation between patients and healthcare providers. Also, patient education ensures that patients are well-informed about their own health and they could avoid any deterioration and disability due to bad practices. Finally, an increased understanding helps patients to make informed decisions about their healthcare avenues.</p>

2021 ◽  

Thermal and massage therapies have long been used to control pain. Although spinal thermal massage (STM) has been used worldwide, its effectiveness has not been proven in a controlled clinical study. We here conducted a non-randomized controlled trial to assess the pain-relieving and immunomodulatory effects of STM in old-aged patients experiencing pain or disability. The experimental group was treated with STM five times a week for 8 weeks and rehabilitative regular care (RRC). The control group was treated with only RRC. Pain and immunological parameters were tested before treatment and after 4 and 8 weeks of treatment. The scores of three pain parameters were lowered by STM, and the differences between the groups were statistically significant at the two time points (p < 0.01). Quality of life determined using the 3-level EuroQol five-dimensional questionnaire scores was significantly higher in patients in the experimental group than those in the control group. Effect sizes (ES) were in the range of medium to large in the pain-related measures (0.54–1.22). The total leukocyte counts and the proportions of lymphocytes and subsets were not significantly different between the groups, whereas the proportions of monocytes and natural killer (NK) cells were higher in the experimental group than in the control group after 8 weeks (p < 0.05). The production of interleukin (IL)-4 and interferon γ in T cells was not significantly different between the groups, whereas the production of IL-2 was high in the control group. However, there was a significant increase in IFN-γ production by NK cells in the experimental group (at 4 weeks, p < 0.05). ES were medium in the immunological measures (0.53–0.68). No significant difference was observed in the production of proinflammatory cytokines, IL-1β, tumor necrosis factor α, or IL-6 between the groups. In conclusion, STM treatment has a positive effect on subjective pain and quality of life. It also enhanced NK cell proportion and activity, suggesting that STM may be beneficial in the prevention of viral diseases and cancer in old-aged people.


2018 ◽  
Vol 2 (2) ◽  
pp. 57-67
Author(s):  
S.Airiza Ahmad ◽  
Iman Supandiman ◽  
Soemarmo Markam ◽  
Riwanti Estiasari ◽  
Graeme Hankey

Background: At present, the management of stroke focuses not only on the acute stage of saving the penumbra but also on the secondary prevention of managing the potential sequel following stroke, preventing the occurrence of another attack, and improving the quality of life. Continuous role of caregivers in supporting stroke survivor after passing the acute phase is therefore invaluable. Caregiver education program (CEP) was routinely used as a part of discharge plan on acute stroke patients in stroke unit in Indonesia. This study aims to evaluate the effect of CEP as one of stroke rehabilitation modalities using a historical data that still correlated to the practice in stroke unit nowadays. Methods: A single-blinded randomized controlled trial was performed on 172 subjects of first-ever stroke with no other comorbidities and not having invasive treatment on the recruitment time. The subjects were randomly allocated into two groups: a group receiving CEP (n=88) as the experiment group and a control group (n=84). A four-session CEP, held since the second week of admission by interactive discussion using overhead projector and poster, was performed by a neurologist to the caregiver member of experiment group stroke survivor. The outcome of functional independence and mortality on the third month post-onset was assessed using Barthel activity daily living (ADL) index and the mortality report, respectively. Results: No statistical difference was found on the baseline of the two groups. CEP significantly increased the functional independence (RR=1.30, 95% CI 1.03-1.63) of stroke survivor. Despite the insignificant effect on three-month survival, the group receiving CEP had less mortality rate over time. Conclusion: Caregiver education program had a positive outcome on the patient’s functional independence. Thus, it improves the quality of life.


2021 ◽  
pp. 109980042110618
Author(s):  
Mei-Chen Lee ◽  
Shu-Fang Vivienne Wu ◽  
Kuo-Cheng Lu ◽  
Wen-Hug Wang ◽  
Yen-Yen Chen ◽  
...  

This longitudinal study with a randomized controlled trial evaluated the long-term effectiveness of the patient-centered self-management intervention program on the control of blood pressure and renal function, as well as the quality of life of patients with hypertensive nephropathy. The control group ( n = 38) received usual care while the experimental group ( n = 38) participated in a patient-centered self-management program. After the pre-test, the intervention was performed with the experimental group once a week for a total of 4 weeks. Then, the post-test was performed 1, 3, and 6 months later. A questionnaire was used to collect the demographic data and disease characteristics, laboratory data, and quality of life scale. This study tracked three time points (i.e., 1, 3, and 6 months) after the intervention and found that the experimental group achieved significant results in controlling systolic blood pressure ( p < 0.001), diastolic blood pressure ( p = 0.007), and eGFR ( p = 0.013). Significant results were achieved in the overall quality of life ( p < 0.001) and the quality of life in the physical (PHC; p < 0.001) and mental health components (MHC; p < 0.001). Furthermore, the effects in the experimental group lasted for as long as 6 months and were better than those in the control group. Moreover, this program can provide nursing staff with a reference different from traditional health education methods.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Raphi ◽  
Soheila Bani ◽  
Mahmoud Farvareshi ◽  
Shirin Hasanpour ◽  
Mojgan Mirghafourvand

Abstract Background Giving a healthy birth plays a vital role in a person’s personality development, but giving unhealthy birth and abortion can increase the risk of a range of mental disorders and psychological harms including reduced well-being and quality of life. Psychological interventions can reduce the problems of individuals, so the present study was conducted to evaluate the effect of counseling with hope therapy on psychological well-being (primary outcome) and quality of life (secondary outcome) of women with an experience of abortion. Method This randomized controlled trial was conducted in Alzahra and Taleghani educational and medical centers in Tabriz, Iran, on 52 women aged 16 years and above whose pregnancies led to abortion in 2020–21. Participants were assigned to intervention and control groups using random blocking method. The intervention group received counseling with hope therapy approach in 8 sessions of 45 min twice a week. The psychological well-being and WHO Quality of Life (WHOQOL) questionnaires were completed before the intervention and immediately and 4 weeks after the intervention. Independent t-test and repeated measures ANOVA were used to compare the outcomes in two groups. Results After the intervention based on the repeated measures ANOVA test and by adjusting the baseline score, the mean total score of psychological well-being in the counseling group was significantly higher than that in the control group (adjusted mean difference (AMD): 76.76; 95% confidence interval (95% CI): 63.81 to 89.70; P < 0.001). Also, the mean total score of quality of life in the counseling group was significantly higher than in the control group (AMD: 7.93; 95% CI: 6.38 to 9.46; P < 0.001). The mean score of all sub-domains of psychological well-being and quality of life in the counseling group was significantly higher than that in the control group (P < 0.05). Conclusion Using hope therapy can improve the psychological well-being and quality of life of women after abortion. However, further clinical trials are required before making a definitive conclusion. Trial registration Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N60. Date of registration: 17 Dec 2020. Date of first registration: 20 Dec 2020.


2019 ◽  
Vol 34 (3) ◽  
pp. 345-356
Author(s):  
Nan Xia ◽  
Jan D Reinhardt ◽  
Shouguo Liu ◽  
Juanjuan Fu ◽  
Caili Ren ◽  
...  

Objective: To examine the effectiveness of a set of rules for referral and therapy input in a three-tiered physiotherapy program on activities of daily living (ADL), motor function, and quality of life of stroke survivors. Design: Randomized controlled study. Setting: Rehabilitation departments of 11 teaching hospitals. Subjects: A total of 285 participants with stroke. Outcome measures: Primary outcome was ADL independence measured with the Modified Barthel Index (MBI) at weeks 3, 6, 9, 13, and 17. Secondary outcomes were motor function and quality of life measured with Fugel-Meyer Assessment (FMA) and Stroke-Specific Quality-of-Life (SSQOL) scale. Intervention: Two complementary sets of rules governing rehabilitation delivery were introduced: a set of criteria that determined when someone ought to move from tier 1 onto tier 2, and from tier 2 onto tier 3, and a second set of rules that determined the amount and type of physiotherapy input given in each tier. Control group participants received conventional rehabilitation without any specified guidelines. Results: With a difference of 3.97 (95% confidence interval (CI): 1.59–6.36), MBI increased stronger in the study group than in controls between baseline and week 3 ( P = 0.001). This difference could be sustained until study end-point. No significant differences were found for FMA. Differences in increase of SSQOL were higher in the intervention than control at week 9 ( P < 0.05). Conclusion: Introduction of a set of rules for referral and therapy input at different stages of rehabilitation partially improved patients’ ADL and quality of life, but did not improve motor function.


2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
C Karadas ◽  
M Oksul ◽  
N Ozer ◽  
L Ozdemir

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim Mindfulness meditation (MM) leads to controlled blood pressure and positive improvements in other symptoms which may trigger acute coronary diseases. The present randomized controlled study was aimed to investigate the effect of the MM on fatigue, kinesiophobia, and the quality of life (QoL) in patients with acute MI. Method The study was carried out with 56 MI patients. Participants were randomly assigned to meditation group (MG; n = 28) or control group (CG; n = 28).  The MG patients received a 15 min MM session comprising sitting and breathing for a total of eight weeks, while the CG patients received only a single-time attention-matched education. Piper Fatigue Intervention, Tampa Scale for Kinesiophobia-Heart and MacNew Quality of Life scales were utilized for data collection. Results After completion of the 8-week MM, any significant difference was not found in the fatigue scores of the patients (p &gt; 0.05). On the other hand, kinesiophobia scores in the MG were significantly lower in the 4th, 8th and 12th weeks (p &lt; 0.05). Similarly, the QoL scores were significantly higher in the MG in 8th week (p &lt; 0.05). Significant change in the emotional function sub-dimension of QoL continued in the follow-up assessment at 12th week (p &lt; 0.05). Conclusion The MM can significantly improve the QoL and decrease kinesiophobia in patients with MI. Beneficial effect of MM is maintained particularly in the emotional aspect. Based on the results of the study, MM may be recommended as a mind-body based complementary approaches within the scope of secondary protection after MI. Comparison of the study groupsGroupBaseline(Mean ± SD)4th week(Mean ± SD)8th week(Mean ± SD)12th week(Mean ± SD)PFSMM2.08 ± 1.870.90 ± 0.990.47 ± 0.780.44 ± 0.76CG1.56 ± 2.011.12 ± 1.590.98 ± 1.520.76 ± 1.33tp1.004 0.32-0.6210.54-1.5840.12-1.0850.28TSK-HMM40.25 ± 5.0436.18 ± 4.4934.39 ± 4.6134.96 ± 4.71CG41.71 ± 7.2841.89 ± 6.7441.82 ± 5.8441.00 ± 5.54tp-0.8750.39-3.7340.001-5.279 0.000-4.3900.00MacNewMM5.04 ± 0.715.53 ± 0.455.76 ± 0.475.77 ± 0.47CG5.17 ± 0.855.32 ± 0.605.37 ± 0.525.53 ± 0.46t; p-0.640; 0.531.436; 0.162.933; 0.0051.964; 0.06(Mean ± SD): Mean ± Standard Deviation; PFS: Piper Fatigue Scores; TSK-H: Tampa Scale for Kinesiophobia-Heart; MacNew: MacNew Quality of life Scale; EFS: emotional functioning sub-dimension; PFS: physical functioning sub-dimension; SFS: social functioning sub-dimension; t= Student T Test value; p&lt; 0.05


2021 ◽  

Background: Menopause is a natural part of women's lives and is associated with a series of complications that can impair their quality of life. This study was conducted to determine the effect of educational interventions based on the Multi-Theory Model (MTM) on the quality of life among menopausal women. Methods: This randomized controlled trial was conducted on 80 menopausal women who met the inclusion criteria and were selected through the multi-stage stratified random sampling method. The participants were randomly allocated to either the control or intervention group (40 subjects per group). The intervention group participated in five 45-min educational sessions based on the MTM on the predetermined days of the week. The quality of life level scores were collected at baseline, immediately, and three months after the intervention using the Menopause-Specific Quality of Life questionnaire (MENQOL). On the other hand, the control group did not receive any intervention during the study period. Results: Analysis of variance of repeated measures showed a significant interaction between time and intervention. Therefore, the independent t-test was used to compare the mean score of quality of life, before, immediately, and three months after the intervention. The results showed a significant difference between the two groups regarding the scores immediately after and three months after the intervention. Conclusion: Structured educational program based on the MTM could be used as a simple and noninvasive intervention that helps menopausal women’s general health through menopausal symptoms relief, thereby improving their quality of life. Further interventions with larger sample sizes may be required to confirm these findings.


2021 ◽  
pp. 105477382110461
Author(s):  
Zeynel Urcan ◽  
Merve Kolcu

Nurse-led education and follow-up for stroke patients may facilitate management and improve quality of life. This study investigated the effect of a nurse-led education program for stroke patients on sleep and life quality. A total of 92 stroke patients (46 in the intervention group, 46 in the control group) aged 18 to 75 years who were independently mobile (less than or equal to one assistive device) and had no other neurologic or psychiatric disorders or history of sleep disorder prior to stroke were included. Patients randomized to the intervention group completed a 20-week education and follow-up program including information about stroke, rehabilitation, adaptation to daily life, and the importance of sleep quality. In the posttest, the intervention group had significantly higher sleep quality and stroke-specific quality of life scores than the control group. This study may serve as a guide for nurses who work with stroke patients.


2016 ◽  
Vol 23 (8) ◽  
pp. 716-724 ◽  
Author(s):  
Michel Tiede ◽  
Sarah Dwinger ◽  
Lutz Herbarth ◽  
Martin Härter ◽  
Jörg Dirmaier

Introduction The * Equal contributors. health-status of heart failure patients can be improved to some extent by disease self-management. One method of developing such skills is telephone-based health coaching. However, the effects of telephone-based health coaching remain inconclusive. The aim of this study was to evaluate the effects of telephone-based health coaching for people with heart failure. Methods A total sample of 7186 patients with various chronic diseases was randomly assigned to either the coaching or the control group. Then 184 patients with heart failure were selected by International Classification of Diseases (ICD)-10 code for subgroup analysis. Data were collected at 24 and 48 months after the beginning of the coaching. The primary outcome was change in quality of life. Secondary outcomes were changes in depression and anxiety, health-related control beliefs, control preference, health risk behaviour and health-related behaviours. Statistical analyses included a per-protocol evaluation, employing analysis of variance and analysis of covariance (ANCOVA) as well as Mann-Whitney U tests. Results Participants’ average age was 73 years (standard deviation (SD) = 9) and the majority were women (52.8%). In ANCOVA analyses there were no significant differences between groups for the change in quality of life (QoL). However, the coaching group reported a significantly higher level of physical activity ( p = 0.03), lower intake of non-prescribed drugs ( p = 0.04) and lower levels of stress ( p = 0.02) than the control group. Mann-Whitney U tests showed a different external locus of control ( p = 0.014), and higher reduction in unhealthy nutrition ( p = 0.019), physical inactivity ( p = 0.004) and stress ( p = 0.028). Discussion Our results suggest that telephone-based health coaching has no effect on QoL, anxiety and depression of heart failure patients, but helps in improving certain risk behaviours and changes the locus of control to be more externalised.


2015 ◽  
Vol 58 (3) ◽  
pp. 535-549 ◽  
Author(s):  
Mara R. Kapsner-Smith ◽  
Eric J. Hunter ◽  
Kimberly Kirkham ◽  
Karin Cox ◽  
Ingo R. Titze

PurposeAlthough there is a long history of use of semi-occluded vocal tract gestures in voice therapy, including phonation through thin tubes or straws, the efficacy of phonation through tubes has not been established. This study compares results from a therapy program on the basis of phonation through a flow-resistant tube (FRT) with Vocal Function Exercises (VFE), an established set of exercises that utilize oral semi-occlusions.MethodTwenty subjects (16 women, 4 men) with dysphonia and/or vocal fatigue were randomly assigned to 1 of 4 treatment conditions: (a) immediate FRT therapy, (b) immediate VFE therapy, (c) delayed FRT therapy, or (d) delayed VFE therapy. Subjects receiving delayed therapy served as a no-treatment control group.ResultsVoice Handicap Index (Jacobson et al., 1997) scores showed significant improvement for both treatment groups relative to the no-treatment group. Comparison of the effect sizes suggests FRT therapy is noninferior to VFE in terms of reduction in Voice Handicap Index scores. Significant reductions in Roughness on the Consensus Auditory-Perceptual Evaluation of Voice (Kempster, Gerratt, Verdolini Abbott, Barkmeier-Kraemer, & Hillman, 2009) were found for the FRT subjects, with no other significant voice quality findings.ConclusionsVFE and FRT therapy may improve voice quality of life in some individuals with dysphonia. FRT therapy was noninferior to VFE in improving voice quality of life in this study.


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