Health status and self-management in patients with inflammatory arthritis-A five-year follow-up study after nurse-led patient education.
Kjersti Grønning, Siriwan Lim, Ola Bratås
PMID 31871717WHAT IT FOUND
In 101 patients with inflammatory arthritis five years after a nurse-led education trial, self-management scores improved slightly and physical function worsened slightly; pain, tiredness, mood and perceived disease activity were unchanged.
Key findings
01Self-management scores rose by a mean 3.69 points, and physical function scores worsened by a mean 0.12 points; changes in well-being, self-efficacy, anxiety and depression, pain, tiredness and perceived disease activity were not significant.
02Higher patient activation and female gender were associated with better self-efficacy in managing arthritis symptoms and pain; less psychological distress and less tiredness were also associated with better symptom self-efficacy.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 101 of 127 eligible patients from the original trial returned consent and questionnaires. The participants had already volunteered for a nurse-led education trial, so they may not represent all patients with inflammatory arthritis. The five-year analysis did not compare the original education and usual-care groups, so changes cannot be attributed to the earlier education. After the trial, the control group was offered the nurse-led education, which further limits comparison between groups. The study explored associations rather than testing long-term effects, and multiple outcomes were analysed. Objective disease activity (DAS28-3) was not measured at five-year follow-up.
Declared interests
The authors declared no competing interests. Funding was from Norges Forskningsråd.
The easy way to misread this
Do not read the five-year changes as proof that nurse-led education caused lasting benefit. The analysis did not compare the original education and usual-care groups at five years, controls were offered education after the trial, and it explored associations rather than testing long-term effects.