title: Six and 12 months' effects of individual joint protection education in people with rheumatoid arthritis: a randomized controlled trial.
abstract: BACKGROUND
  Joint protection (JP) education for people with rheumatoid arthritis (RA) is effective when applying psycho-educational teaching strategies. The Pictorial Representation of Illness and Self Measure (PRISM) was used to identify relevant JP education goals and life aspects, both supporting motivation and behaviour change. The objective of this study was to compare the effects of individual JP education, PRISM-based (PRISM-JP) vs. conventional (C-JP), in people with rheumatoid arthritis (RA).
  
  
  METHODS
  An assessor-blinded randomized controlled trial was conducted in four rheumatology centres. Patients were randomized to PRISM-JP or C-JP, consisting of five JP education sessions over three months. Primary outcome was JP behaviour at six and 12 months.
  
  
  RESULTS
  A total of 53 RA patients participated. The PRISM-JP group (n = 26) demonstrated significantly more JP behaviour at six months (effect size ES = 0.32; p = 0.02) and 12 months (ES = 0.28; p = 0.04) than the C-JP (n = 27). Within-group analysis showed that the JP intervention was successful at six and 12 months in both groups (p < 0.001). At 12 months the PRISM-JP group had better JP self-efficacy (p = 0.02) and grip strength (p = 0.04) compared with baseline.
  
  
  CONCLUSIONS
  PRISM-JP was more effective than C-JP in terms of long-term JP behaviour at six and 12 months.
authors.affiliation: Department of Health, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland. karin.niedermann@zhaw.ch
authors.forename: Karin
authors.initials: K
authors.lastname: Niedermann
authors.forename: Stefan
authors.initials: S
authors.lastname: Buchi
authors.forename: Adrian
authors.initials: A
authors.lastname: Ciurea
authors.forename: Regula
authors.initials: R
authors.lastname: Kubli
authors.forename: Claudia
authors.initials: C
authors.lastname: Steurer-Stey
authors.forename: Peter M
authors.initials: PM
authors.lastname: Villiger
authors.forename: Rob A
authors.initials: RA
authors.lastname: De Bie
mesh_terms: D000203:Activities of Daily Living; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000523:psychology / Q000534:rehabilitation*; D001521:Behavior Therapy; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D009788:Occupational Therapy / Q000379:methods; D010146:Pain / Q000517:prevention & control; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life; D020377:Self Efficacy; D016896:Treatment Outcome