Objective: To investigate seven common arthritis self-management methods used by people with rheumatoid arthritis (RA) by studying their frequency of use and the patients' belief in their benefits. Also to look at how people obtained information about such methods.
Design: Cross-sectional survey.
Subjects and setting: Forty-one people with RA attending a rheumatology outpatient department at a large district general hospital.
Results: Twenty-three recalled receiving some self-management advice from rheumatology team members, but most stated the commonest source of information was arthritis books and leaflets (n = 29). Two-thirds used technical aids and rest on a daily basis, half used exercise and heat (half doing so daily). A quarter to a half used relaxation, joint protection and working splints (half doing so daily).
Conclusion: People with RA reported using three or four self-management methods simultaneously to help control symptoms. In the main, believing a method to be beneficial was strongly related to its use. However, exercise and joint protection, whilst widely believed to be beneficial, were less used. People reported problems with knowing how to do these correctly, having insufficient time to practise sufficiently and difficulty in establishing habits.
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References
1.
Lorig K, Fries JF. The arthritis helpbook, second edition. Reading, MA: Addison-Wesley, 1986.
2.
Riggs GK, Gall EP eds. Rheumatic diseases: rehabilitation and management. Boston: Butterworths, 1984.
3.
Melvin J.Rheumatic disease: occupational therapy and rehabilitation, third edition. Philadelphia: FA Davies, 1989.
4.
Taal E, Rasker JJ, Seydel ER, Wiegman O. Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis. Pain Educ Counselling1993; 20: 63–76.
5.
Lorig K, Lubeck D, Kraines RG et al. Outcomes of self-help education for patients with arthritis. Arthr Rheum1985; 28: 680–685.
6.
Bradley LA. Adherence with treatment regimens among adult RA patients: current status and future directions. Arthr Care Res1989; 2: S33–S39.
7.
Hammond A.Joint Protection Behavior in patients with rheumatoid arthritis following an education programme. Arthr Care Res1994; 7: 5–9.
8.
Hollings EM, Howarth RJ. Supply and use of aids and appliances; a study of 119 patients with rheumatoid arthritis. Br J Occup Ther1978; 41: 336–339.
9.
Howarth RJ.Use of aids during the first three months after total hip replacement. Br J Rheum1983; 22: 29–35.
10.
Brody E, Kleban M. Day to day mental and physical health symptoms: a report on daily logs. Gerontologist1983; 23: 75–85.
11.
Conn VS.Joint self-care by older adults. Rehabil Nursing1990; 15: 182–186.
Hampson SF, Glasgow RG, Zeiss AM, Birskovch SF, Foster I, Lines A. Self-management of osteoarthritis. Arthr Care Res1993; 6: 17–22.
14.
Steinbrocker O, Traeger C, Batteman RC. Therapeutic criteria in rheumatoid arthritis. JAMA1949; 14: 659–662.
15.
Fries JF, Spitz P, Kraines RG, Holman H. Measurement of patient outcome in arthritis. Arthr Rheum1980; 23: 137–145.
16.
Callahan LH, Brooks RH, Sumney JA, Pincus T. Quantitative pain assessment for routine care of rheumatoid arthritis patients using a pain scale based on activities of daily living and a visual analogue pain scale. Arthr Rheum1987; 30: 630–635.
17.
Anderson JL, Dodman S, Kopelman M, Fleming A. Patient information recall in a rheumatology clinic. Rheumatol Rehabil1979; 18: 18–22.
18.
Feinberg J. The effect of patient–practitioner interaction on compliance: a review of the literature and application in rheumatoid arthritis. Patient Educ Counselling1988; 11: 171–187.
19.
Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q1988; 15(2): 175–183.
20.
McCubbin JA. Resistance exercise training for persons with arthritis. Rheum Dis Clin North Am1990; 16: 931–943.
21.
Brighton S, Lubbe J, van der Merwe CA. The effect of a long-term exercise programme on the rheumatoid hand. Br J Rheum1993; 32: 392–395.
22.
Hoenig H, Groff G, Pratt K, Goldberg E, Franck W. A randomised controlled trial of home exercise on the rheumatoid hand. J Rheumatol1993; 20: 785–789.
23.
Dellhag B, Wollersjo I, Bjelle A. Effect of active hand exercise and wax bath treatment in rheumatoid arthritis patients. Arthr Care Res1992; 5: 87–92.
24.
Ley P.Improving patients' understanding, recall, satisfaction and compliance. In: Broome AK ed. Health psychology: processes and applications. London: Chapman & Hall, 1989: 71–102.
25.
Bandura A.Self-efficacy: towards a unifying theory of behavioural change. Psychol Rev1977; 84: 191–215.
26.
Gentile AM.Skill acquisition: action, movement and neuromotor processes. In: Carr JH et al. eds. Movement science: foundations for physical therapy. London: Heinemann, 1987.
27.
Warner L, McNeill EM. Mental imagery and its potential for physical therapy. Phys Ther1988; 68: 516–521.
28.
Kanfer FH, Gaelick L. Self management methods. In: Kanfer FH, Goldstein AP eds. Helping people change: a handbook of methods, third edition. New York: Pergamon Press, 1986: 283–345.
