Rheumatoid Arthritis Self-Efficacy Research Articles

Effectiveness of a novel digital patient education programme to support self-management of early rheumatoid arthritis: a randomized controlled trial.

To evaluate the effectiveness of a novel digital patient education (PE) programme in improving self-management in patients newly diagnosed with rheumatoid arthritis (RA). This was a parallel, open-label, two-armed, randomized controlled trial with superiority design. Patients from five rheumatology clinics were randomized into digital PE (intervention) or face-to-face PE (control). The primary outcome was self-efficacy, measured by average difference in the Rheumatoid Arthritis Self-Efficacy (RASE) score from baseline to month 12. Secondary outcomes were RA knowledge, health literacy, adherence and quality of life. Healthcare utilization data and digital PE programme usage were recorded. Self-efficacy, knowledge and health literacy data were analysed using mixed-effects repeated measures modelling; adherence using logistic regression, and quality of life and healthcare utilization using descriptive statistics with the Wilcoxon rank-sum test. Of the 180 patients randomized (digital PE, n = 89; face-to-face PE, n = 91), 175 had data available for analysis. Median age was 59.0 years and 61% were women. The average difference in self-efficacy between groups from baseline to month 12 was significant by a -4.34 difference in RASE score, favouring the intervention group (95% CI: -8.17 to -0.51; P = 0.026). RA knowledge, health literacy and quality of life showed minor improvements over time but no difference between groups, except out-patient clinic contacts, which were fewer in the intervention group. The findings suggest that digital PE is effective in improving self-efficacy and therefore self-management in patients with early RA. This intervention has potential to lower healthcare costs by decreasing out-patient clinic contacts. clinicaltrials.gov, NCT04669340.

Factors Affecting Self-Management of Patients with Rheumatoid Arthritis

Background: Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease that is associated with progressive joint degeneration, limitation of physical activity and disability. Aim: the study aimed to assess factors affecting self-management of patients with rheumatoid arthritis. Design: A descriptive exploratory research design was utilized. Setting: This study was carried out at the National Medical Institute of Damanhur –affiliated to the General Organization for teaching hospitals and Institutes at the Medical clinics in the out- patient department. Study subjects: A purposive sample of 100 adult patients of both genders with rheumatoid arthritis. Tools: Patient interviewing questionnaire, Rheumatoid Arthritis Disease Activity Scale, Rheumatoid Arthritis Self-Efficacy and Rheumatoid Arthritis Self-Management practices Questionnaire. Results: About 58% of the studied patients had unsatisfactory level of knowledge about the self-management of RA. Also, 32% of them had low disease activity. Moreover, 52% of them had moderate level of self-efficacy and 50% of them had moderate level of total self-management. Conclusion: More than half of the studied patients had unsatisfactory level of knowledge about rheumatoid arthritis. Also, one third of them had low level of disease activity. Moreover, more than half of the studied patients had moderate level of self-efficacy and half of them had moderate level of total self-management. There was highly significant positive correlation between total knowledge of the studied patients and self-efficacy with self- management. While, there was highly significant negative correlation between total disease activity of the studied patients and self- management. Recommendation: Self-management educational program should become an integrated part of the total management of patients with rheumatoid arthritis.

Self‐Efficacy as an Outcome Measure and its Association with Physical Disease‐Related Variables in Persons with Rheumatoid Arthritis: A Literature Review

Studies have demonstrated a positive impact of patient education on self-efficacy in persons with rheumatoid arthritis (RA). However, the relationship between self-efficacy, physical disease-related variables and educational interventions has not yet been reviewed. The aims of this study, in relation to persons with RA, were: 1) to provide an overview of the existing research into the association between self-efficacy and physical disease-related variables and, with this knowledge, 2) to provide an overview of the existing research on the effect of different types of educational interventions on self-efficacy. A systematic literature search was performed using eight databases, based on the terms 'rheumatoid arthritis' AND 'self-efficacy'. In total, 74 studies reporting associations between self-efficacy and physical disease-related variables and using self-efficacy as an outcome measure in educational interventions were included. The scores obtained by the most commonly used questionnaire, the Arthritis Self-Efficacy Scale (ASES), was highly associated with physical disability, pain, fatigue and disease duration. If educational activities had a positive impact on self-efficacy, disease-related variables usually improved as well. Evidence is scarce as to whether disease-related variables affect patients' self-efficacy or vice versa and whether individual consultations can affect patients' self-efficacy. The scores attained by the ASES is highly associated with physical disease-related variables. This relationship requires further research using a specific study design to restrict bias when evaluating the impact of interventions on self-efficacy in persons with RA. Research is needed on whether individual consultations can affect patients' self-efficacy. Disease-related variables do not affect the Rheumatoid Arthritis Self-Efficacy (RASE) questionnaire but this needs further exploration.

Development and validation of a self-efficacy scale for use in British patients with rheumatoid arthritis (RASE).

Current arthritis self-efficacy scales have attracted some criticism. Therefore, the aim of this study was to develop and validate a measure of self-efficacy for use in British rheumatoid arthritis patients [Rheumatoid Arthritis Self-efficacy (RASE) scale]. Phase I: item generation of self-management strategies by rheumatology professionals and patients to create a pilot RASE. Phase II: examination of the internal structure (n=88) using correlation coefficients and principal component analysis (PCA) to create the final RASE. Phase III: reliability in 23 patients. Phase IV: comprehension, construct validity and sensitivity to change in 48 rheumatoid arthritis patients undergoing a self-management programme, using correlation coefficients, PCA and inter-item correlation. Phase I: of 166 self-management items generated, 100 commonly cited items were selected for the pilot RASE. Phase II: using a correlation matrix and PCA, a 28-item RASE was created. Phase III: good 4-week reliability was seen (r=0.889, P<0.001). Phase IV: the final RASE was shown to be independent of mood, disease status and disability and weakly associated with other self-efficacy scales (r=0.313, P<0.05). The RASE was sensitive to change following an education programme (+5.167, P<0.025), and was associated with behaviour initiation (r=0.35, P<0.01). Careful construction means that the RASE examines beliefs in potential ability to perform tasks, rather than actual ability, performance or outcome expectancy. It shows good face validity and reliability, plus reasonable construct validity and sensitivity. Further studies are needed to support the validation of this new scale.