Title. Effects of a self‐management arthritis programme with an added exercise component for osteoarthritic knee: randomized controlled trial. Aim.  This paper is a report of a study to assess the effect of an adapted arthritis self‐management programme with an added focus on exercise practice among osteoarthritic knee sufferers. Background.  Osteoarthritis of the knee is a major source of loss of function in older people. Previous studies have found self‐management programmes to be effective in increasing arthritis self‐efficacy and in mastery of self‐management practice. Method.  A randomized control trial was carried out from December 2002 to May 2003 and 120 participants (65·9%, including 67 in intervention group and 53 in control group) completed the 16‐week postintervention assessments. Outcome measures included arthritis self‐efficacy, use of self‐management techniques, pain intensity and daily activity. Findings.  At 16 weeks, there was a ‘statistically’ significant improvement in the arthritis self‐efficacy level (P ≤ 0·001), in most of the self‐management skills, i.e. use of cold and hot compresses, in two of three joint protective practices (P ≤ 0·001; P = 0·01), an increase in the duration of light exercise practice (P ≤ 0·001), reduction of current arthritis pain (P ≤ 0·001) and in the ability to perform daily activities (P ≤ 0·001) among the intervention group but not for the control group (P‐range from 0·04 to 0·95). One joint protective practice showed a statistically significant increase in both groups (P ≤ 0·001). Conclusion.  Our findings add to evidence showing short‐term beneficial effects of self‐efficacy theory in education programmes. Self‐efficacy theory has great potential for empowering sufferers of chronic conditions to live with their illness.

The aim was to assess the self-efficacy and health outcomes of an adopted Arthritis Self-Management Programme (ASMP) among osteoarthritic knee sufferers in Hong Kong at 1 year. An experimental study with 95 participants assigned randomly to the intervention (n=45) or control group (n=50). Seventy-seven (81.1%) participants joined at least one out of three follow-ups in the 12 month period. Participants in the intervention group received a 6-week ASMP with an added exercise component in two general clinics. Outcome measures included arthritis self-efficacy (ASE) and health outcomes including pain and fatigue rating, self-rated health, daily activities limitation and number of unplanned arthritis-related medical consultations. Mean change (12 months minus baseline) and the effect size of the outcome measures were calculated by Mann-Whitney U test and nQuery Advisor 4.0. At 12 months, there were significant reductions of current pain (p=0.0001), pain at night (p=0.001), pain during walking (p=0.01) and number of unplanned arthritis-related medical consultations (p=0.03) and a significant increase in ASE for pain (p=0.01) and other symptoms (p=0.02) and self-rated health (p=0.04) among the intervention group but not for the control group. However, there were similarities in outcome measures of pain while switching from a sitting to a standing position, fatigue rating and physical functional limitation (p=0.15; p=0.22 and p=0.91, respectively) for both groups. Our findings add to the evidence that the modified arthritis empowering programme improved perception of control of osteoarthritis and three health outcomes after 12 months of treatment.

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Early adolescence is a period of rapid cognitive, social, emotional and physical changes. During this period, early adolescents usually lack the ability to cope when they experience stress, which is usually family and school-related. If they cannot cope with such stress, they may fail to develop in a healthy manner and may develop habits harmful to their health such as substance abuse. To enhance positive behaviour in those in early adolescence coping with stress, a school-based project was implemented using focus group interviews, an open forum and follow-up interviews and journals. The objectives were to identify the stressors encountered by the students and their ability to cope, to develop and implement an educational activity to promote positive coping behaviour and to evaluate the effectiveness of the educational activity. The findings of the evaluation support the view that an early prevention programme for promoting positive coping behaviour to early adolescents is useful.