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Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study
Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.ORCID iD: 0000-0001-5647-086X
Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.ORCID iD: 0000-0002-6294-538X
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden & Faculty of Health Care and Nursing, Gjøvik University College, Gjøvik, Norway.
School of Health Sciences, Jönköping University, Jönköping, Sweden.
Show others and affiliations
2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, 1500-1514 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To evaluate the effects of a self-care promoting problem-based learning programme for people with rheumatic diseases in terms of health-related quality of life, empowerment, and self-care ability.

Background: Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long-term benefits of patient education.

Design: Randomized controlled trial.

Methods: A randomized controlled design was selected with test at baseline, 1-week and 6-month post-interventions after completed the 1-year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non-parametric tests were used in the analyses.

Results: The participants in the experimental group had statistically significant stronger empowerment after participation in the self-care promoting problem-based learning programme compared with the control group, at the 6-month post-intervention. Approximately, two-thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

Conclusion: The self-care promoting problem-based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem-based learning in patient education to find the very best way to use this pedagogical method in rheumatology care. © 2012 Blackwell Publishing Ltd.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell, 2013. Vol. 69, no 7, 1500-1514 p.
Keyword [en]
empowerment, nursing, patient education, problem-based learning, rheumatic diseases, self-care
National Category
Nursing
Identifiers
URN: urn:nbn:se:hh:diva-20653DOI: 10.1111/jan.12008ISI: 000319829000006PubMedID: 22973890Scopus ID: 2-s2.0-84878623956OAI: oai:DiVA.org:hh-20653DiVA: diva2:586026
Note

Funding: The Swedish Rheumatism Association, the Region Halland, the South Regional Health Care Committee, the Stig Thunes Foundation Fund for Health Care Research, the Norrbacka-Eugenia Foundation, the Association of Rheumatology Nurses in Sweden, and the Spenshult Hospital for Rheumatic Diseases.

Available from: 2013-01-10 Created: 2013-01-10 Last updated: 2017-04-03Bibliographically approved
In thesis
1. Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a desciptive and interventional study
Open this publication in new window or tab >>Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a desciptive and interventional study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis with a salutogenic approach was to describe health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, and to evaluate the effects of an intervention study with a self-care promoting PBL-program for people with rheumatic diseases having chronic musculoskeletal pain, sleep disturbances and/or fatigue.

Methods: This thesis is comprised of four samples: a randomly selected sample from a Swedish general population (study I) and three different samples containing people with rheumatic diseases registered at a hospital for rheumatic diseases in the southwest of Sweden (studies II, III and IV). Study I had a longitudinal cohort design with an eight-year follow-up in a general population. There were 1109 participants without chronic pain and 700 participants with chronic musculoskeletal pain. Study II had a longitudinal cohort design with participants with rheumatic diseases (n=185) 12 months after rehabilitation at a hospital for rheumatic diseases. Study III had a descriptive qualitative design with a phenomenological approach based on a reflective life-world perspective. Twelve participants were interviewed about their experiences about health-promoting self-care. Study IV had a randomised controlled design with post-test six months after the one-year self-care promoting problem-based learning (PBL) program for people with rheumatic diseases. The participants were randomly assigned to the experimental group, 54 participants, or to the control group, 148 participants. Data in studies I, II and IV were analysed with statistics. In study III a Husserlian phenomenological approach based on a reflective life-world perspective was used in the data collection and analysis.

Results: Study I: Although participants without chronic musculoskeletal pain reported better health-related quality of life (HRQL) than participants with chronic musculoskeletal pain, similar health factors were found to promote a better HRQL in the eight-year follow-up. The most important factors were feeling rested after sleep and having good sleep structure. Study II: The most important factors promoting better outcome in HRQL 12 months after rehabilitation in participants with rheumatic diseases were having a strong sense of coherence (SOC), feeling rested after sleep, having work capacity, and having good sleep structure. Study III: The meaning of health-promoting self-care as experienced by people with rheumatic diseases was that self-care takes place against a background of continual hope and belief to be able to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three interrelated constituents elucidated the experiences: dialogue, power struggle and choice. Study IV: At the six month follow-up the participants in the experimental group had stronger empowerment after participation in the self-care promoting PBL-program compared with the control group which only got standard care for people with rheumatic diseases. There were no differences in HRQL, self-care ability, SOC, pain, quality of sleep or fatigue between the experimental group and the control group. The participants in the experimental group also stated that they had implemented lifestyle changes which they had not done without the PBL-program.

Conclusion: The results of this thesis provide a valuable and useful insight in health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, but also in that people with rheumatic diseases have benefit from taking part in patient education with a self-care promoting PBL-program. These results contribute to evidence supporting the introduction of a more salutogenic approach in rheumatology care and research.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, 2011. 164 p.
Series
Dissertation series (School of Health Sciences, Jönköping University), ISSN 1654-3602 ; 17
Keyword
Adult, chronic musculoskeletal pain, empowerment, health factors, HRQL, intervention, patient education, problem-based learning, rheumatic diseases, self-care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-28606 (URN)978-91-85835-16-4 (ISBN)
Public defence
2011-06-01, Forum Humanum, Hälsohögskolan, Jönköping, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2015-07-28 Created: 2015-06-16 Last updated: 2016-10-21Bibliographically approved

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