title: The impact on self-efficacy of different types of follow-up care and disease status in patients with rheumatoid arthritis--a randomized trial.
abstract: OBJECTIVE
  To explore the impact from different types of outpatient care, demographic and disease related variables on self-efficacy beliefs (SE) in patients with established rheumatoid arthritis (RA) after completing an educational program.
  
  
  METHODS
  287 adult RA outpatients with low disease activity and moderate physical disability from two Danish rheumatology clinics were randomized for follow-up care. (1) planned rheumatologist's consultations, (2) a shared care model without planned consultations, (3) planned nursing consultations. The participants' SE were assessed by the Danish versions of the rheumatoid arthritis self-efficacy questionnaire (RASE) and the arthritis self-efficacy scale (ASES). Data were collected at baseline, 3 months and one-year follow up and were explored in random intercept models.
  
  
  RESULTS
  Following an educational programme the nursing group increased or stabilized their SE during the first year compared to the medical and the shared care group. SE in the shared care group did not differ significantly from the medical group. No difference between the groups was seen in disease activity at any time.
  
  
  CONCLUSIONS
  Nursing consultations provide opportunities for maintenance of the patients' SE after patient education.
  
  
  CONCLUSIONS
  Implementation of nursing consultations as part of follow-up care in patients with stable RA is recommended.
authors.affiliation: Institute for Regional Health Research, University of Southern Denmark, Odense C, Denmark. jprimdahl@gigtforeningen.dk
authors.forename: Jette
authors.initials: J
authors.lastname: Primdahl
authors.forename: Lis
authors.initials: L
authors.lastname: Wagner
authors.forename: René
authors.initials: R
authors.lastname: Holst
authors.forename: Kim
authors.initials: K
authors.lastname: Hørslev-Petersen
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000451:nursing* / Q000523:psychology*; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010045:Outpatients; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D015397:Program Evaluation; D012648:Self Care; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires