Efficacy of self-care training program on self-efficacy, compliance, and quality of life among patients with Rheumatoid Arthritis

Abstract

Rheumatoid Arthritis (RA) is an autoimmune disease that can result in significant joint destruction and work disability. Physical and psychosocial adjustment is required to deal with flare-up, pain, restricted mobility and fatigue in daily life. The study assessed the effectiveness of self-care training program on self-efficacy, compliance, and Quality of life (QoL) among patients with RA. Quantitative research approach was utilized in this study. The study employed an experimental pre-test post-test wait list control group design. The study was conducted at the Rheumatology Outpatient department of a tertiary care hospital in India. The participants were randomly allocated to the study and control group. The self-care training program comprising of 6 sessions over a period of 12 weeks was administered to the participants in the study group; whereas routine care was provided to the participants of control group and the research assistant was blinded to the treatment. The pre and post-interventional levels of self-efficacy, compliance, and QOL were assessed on the first, third and fifth months. On completion of post assessment, the control group participants received the same intervention. Lower levels of self-efficacy, compliance and QOL were reported in the pre-test. However, significant improvements were observed in self-efficacy scores of the study group participants in the post-intervention. In the post-intervention, high compliance to drugs and low compliance to exercise, pain and stress management were reported in the study. With regard to QOL, mental health domain of QOL improved compared to physical health domain in the participants of the study group. Significant association was found between self-efficacy scores and education, income, Disease Activity Score (DAS) and global functional status). Likewise, significant association was found between pain compliance and education, DAS, and relapse. Stress management compliance was associated with DAS, and relapse. Lastly, association was found between QOL and age, education, income, marital status, DAS, duration of illness, global functional status, BMI, and medications @ p < 0.05 level. Self-efficacy had a positive correlation with the QoL and compliance to exercise, drugs, and pain management. Self-care training program can play an imperative role in the long-term management of patients with RA. The intervention can be adopted as an evidence based nursing intervention in the management of patients with RA, which improves the self-efficacy, compliance and QOL.