“類風濕性關節炎患者自我管理課程”的成效研究和啓示

Abstract

這項研究，主要是探討病患者在參加“類風濕性關節炎患者自我管理課程”後，在自我療理行為、心理狀態及健康狀況等方面的成效及持續效果。研究採用單組活動前後的比較與設計，共有70名病患者參與是次研究。結果顯示，類風濕患者在療理病徵的信心、建立自我療理炎病的行為、心理狀態以及健康狀況方面，當課程結束時和結束後的1個月，均有顯著進步，並且於結束後6個月，開始達致穩定狀態。參加者在課程結束時和結束後的6個月，亦顯著地減少了使用醫療服務。研究結果更發現早期類風濕患者在課程裏能得到較大益處和進步。由於這許多方面的成果和持續效果，“病人自我療理教育”應加以大力推廣，以彌補傳統醫療的不足，並配合現有醫療制度，發揮更大的治療效果。 This study examines whether the Rheumatoid Arthritis Self-Management Course is effective in, as well as being able to achieve stabilizing effect on, enhancing participants' perception of control over the symptoms, improving health behaviours and health status, and reducing use of health care resources. This is a single group pre-and-post design with a sample of 70 participants. After the intervention and at 1 month follow up, participants show significant improvements in arthritis self-efficacy, self-management behaviour (exercise, cognitive symptoms management and communication with doctors), psychological well-being (sense of helplessness, mood and anxiety) and health status (pain and fatigue). These improvements become stabilized at 6 months follow-up after completion of the program. In addition, the program is found effective in reducing visits to general physician on problems related to arthritis. The results in this study clearly indicate that this community based patient education program can offer substantial benefits for the participants, particularly in terms of perceived self-efficacy on managing various aspects of arthritis, the establishment of positive health behaviour and its stabilizing effects. Therefore the complementary role of patient self-management education to traditional disease-oriented medical services can offer a valuable adjunct to medical care and we strongly advocate for its full implementation.