Self‐management education for persons with arthritis: Managing comorbidity and eliminating health disparities

Abstract

Objective. To compare short-term and long-term effectiveness of the Arthritis Self-Help Course (ASHC) and the Chronic Disease Self-Management Program (CDSMP) for persons with arthritis concerning health care use, health-related quality of life, health behaviors, and arthritis self-efficacy. Methods. Forty-eight workshops were randomized to the ASHC (n ‫؍‬ 26) or CDSMP (n ‫؍‬ 22). A total of 416 individuals, including 365 African Americans, participated. The mean age for each group was 64 years, mean years of education was 11.7, mean number of chronic conditions was 4, and 75-80% of participants in each group were female. Multivariate statistical tests were used to assess effectiveness within and between programs for all workshop participants and African Americans. Results. At 4 months all ASHC participants including African Americans, had significant improvements (P < 0.05) in self-efficacy, stretching and strengthening exercises, aerobic exercises, and general health. All CDSMP participants had statistically significant improvements in self-efficacy, disability, pain, and general health. African American CDSMP participants showed statistically significant improvements in general health. Trends toward improvement (P ‫؍‬ 0.051-0.100) were shown in 5 variables among African American CDSMP participants and in 4 variables among all CDSMP participants. Statistically significant differences between the 2 programs at 4 months were seen in pain and disability in both groups. The CDSMP produced stronger results. Significant results at 1 year within and between programs were minimal for both groups. Conclusion. When populations with arthritis and multiple comorbid conditions are targeted, the CDSMP may be most cost effective.

Effects of Cancer Comorbidity on Disease Management: Making the Case for Diabetes Education (A Report from the SOAR Program)

“…These selfmanagement programs resulted in statistically significant improvements in self-efficacy and health-related quality of life among study participants after 4 months. 25 This study supports the premise that patient education has the ability to improve overall health outcomes in patients with comorbidities. Further research is needed to better understand this relationship.…”

Effects of chronic disease self-management programs for participants with higher depression scores: secondary analyses of an on-line and a small-group program

“…Improvements were found to persist up to 2 years [13,17]. The CDSMP has been widely used and disseminated, and there have been several studies of the small-group CDSMP for participants with chronic diseases in diverse populations, including Spanish speakers in the USA, Chinese in both China and Australia, Bangladeshis in London, African-Americans in the USA, and British in England [18][19][20][21][22][23][24]. For the U.S. National translation study, more than 1,000 people from 22 sites in the USA were recruited for a 1-year longitudinal study [12].…”

Intervenções de enfermagem para o cuidado de pacientes com artrite: revisão integrativa da literatura

“…Um estudo investigou a utilidade da utilização de questionário para melhorar a acurácia da coleta de dados acerca dos sintomas apresentados por idosos a fim de favorecer o planejamento e implementação de intervenções específicas (17) . Outro estudo (16) comparou a eficácia de dois programas educacionais sendo um direcionado especificamente a portadores de artrite e outro programa direcionado a doentes crônicos de maneira geral.…”

“…Outro estudo (16) realizado para comparar a eficácia de dois programas educativos sendo um direcionado especificamente a portadores de artrite (Arthritis Self-Help Course -ASHC) e o outro direcionado a doentes crônicos de maneira geral (Chronic Disease Self-Management Program -CDSMP) o fizeram por meio da avaliação das variáveis: uso de serviços de saúde, saúde geral, comportamentos saudáveis, auto cuidado para artrite, incapacidade funcional e dor. Os programas foram aplicados na forma de 48 workshops randomizados para aplicarem a um ou outro dos temas.…”

“…Observando os resultados encontrados no estudo que comparou dois programas educativos (16) , consideramos que a elaboração de tais programas deve levar em conta os resultados que se pretende atingir. Uma vez que o programa direcionado especificamente para pacientes portadores de artrite mostrou-se mais efetivo para melhorar a prática de exercícios físicos e o programa direcionado para pessoas com problemas crônicos em geral foi considerado mais efetivo para melhorar o controle da dor e a incapacidade funcional, a avaliação do perfil das queixas dos pacientes e de suas necessidades específicas podem fornecer indicações do melhor tipo de programa a se adotar.…”