TY - JOUR
T1 - Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial
AU - Niedermann, Karin
AU - de Bie, Rob A.
AU - Kubli, Regula
AU - Ciurea, Adrian
AU - Steurer-Stey, Claudia
AU - Villiger, Peter M.
AU - Buechi, Stefan
PY - 2011/1
Y1 - 2011/1
N2 - Objective: The modern joint protection (JP) concept for people with rheumatoid arthritis (RA) is an active coping strategy to improve daily tasks and role performance by changing working methods and using assistive devices. Effective group JP education includes psycho-educational interventions. The Pictorial Representation of Illness and Self Measure (PRISM) is an interactive hands-on-tool, assessing (a) the individual's perceived burden of illness and (b) relevant individual resources. Both issues are important for intrinsic motivation to take action and change behaviour. This study compared individual conventional JP education (C-JP) with PRISM-based JP education (PRISM-JP). Methods: An assessor-blinded multicentre randomized controlled trial, including four JP education sessions over 3 weeks, with assessments at baseline and 3 months. Results: In total 53 RA patients participated. At 3 months, the PRISM-JP (n = 26) participants did significantly better compared to the C-JP participants (n = 27) in JP behaviour (p = 0.02 and p = 0.008 when corrected for baseline values), Arthritis Self-efficacy (ASES, p = 0.015) and JP self-efficacy (JP-SES, p = 0.047). Within-group analysis also showed less hand pain (p <0.001) in PRISM-JP group. Conclusion: PRISM-JP more effectively supported learning of JP methods, with meaningful occupations, resource activation and self-efficacy acting as important mediators. Practice implications: PRISM improved patient-clinician communication and is feasible for occupational therapy.
AB - Objective: The modern joint protection (JP) concept for people with rheumatoid arthritis (RA) is an active coping strategy to improve daily tasks and role performance by changing working methods and using assistive devices. Effective group JP education includes psycho-educational interventions. The Pictorial Representation of Illness and Self Measure (PRISM) is an interactive hands-on-tool, assessing (a) the individual's perceived burden of illness and (b) relevant individual resources. Both issues are important for intrinsic motivation to take action and change behaviour. This study compared individual conventional JP education (C-JP) with PRISM-based JP education (PRISM-JP). Methods: An assessor-blinded multicentre randomized controlled trial, including four JP education sessions over 3 weeks, with assessments at baseline and 3 months. Results: In total 53 RA patients participated. At 3 months, the PRISM-JP (n = 26) participants did significantly better compared to the C-JP participants (n = 27) in JP behaviour (p = 0.02 and p = 0.008 when corrected for baseline values), Arthritis Self-efficacy (ASES, p = 0.015) and JP self-efficacy (JP-SES, p = 0.047). Within-group analysis also showed less hand pain (p <0.001) in PRISM-JP group. Conclusion: PRISM-JP more effectively supported learning of JP methods, with meaningful occupations, resource activation and self-efficacy acting as important mediators. Practice implications: PRISM improved patient-clinician communication and is feasible for occupational therapy.
KW - Rheumatoid arthritis
KW - Joint protection
KW - Patient education
KW - Self-efficacy
KW - Occupational therapy
KW - Randomized controlled trial
U2 - 10.1016/j.pec.2010.02.014
DO - 10.1016/j.pec.2010.02.014
M3 - Article
C2 - 20451345
SN - 0738-3991
VL - 82
SP - 42
EP - 48
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 1
ER -