title: Long-term effects of a nurse-led group and individual patient education programme for patients with chronic inflammatory polyarthritis - a randomised controlled trial.
abstract: OBJECTIVE
  To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis.
  
  
  BACKGROUND
  Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n = 71) or a waiting list (n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3).
  
  
  RESULTS
  The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8·2 (95% CI, 1·6-14·8; p-value = 0·015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2·6 (95% CI, -1·8 to 7·1; p-value = 0·245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0·3 (95% CI, -0·5 to -0·1; p-value = 0·001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change -5·0 (95% CI, -8·6 to -1·3; p-value = 0·008), Arthritis Impact Measurement Scales - 2 Social, mean change 0·3 (95% CI, 0·1-0·5; p-value = 0·008), and Hospital Anxiety and Depression Scale total, mean change 1·4 (95% CI, 0·3-2·5; p-value = 0·013).
  
  
  CONCLUSIONS
  A combination of group and individual patient education has a long-term effect on patients' global well-being.
  
  
  CONCLUSIONS
  Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less time-consuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.
authors.affiliation: Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway; Faculty of Nursing, Sør-Trøndelag University College, Trondheim and Department of Rheumatology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Grønning
authors.forename: Toril
authors.initials: T
authors.lastname: Rannestad
authors.forename: Johan F
authors.initials: JF
authors.lastname: Skomsvoll
authors.forename: Lisbeth Ø
authors.initials: LØ
authors.lastname: Rygg
authors.forename: Aslak
authors.initials: A
authors.lastname: Steinsbekk
mesh_terms: D001168:Arthritis / Q000451:nursing*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000458:organization & administration*; D020377:Self Efficacy
keywords: chronic illness; coping; patient teaching; psychological well-being; randomised controlled trials; self-efficacy