Preliminary Efficacy of a Self-Management Programme to Improve Quality-of-Life in Patients With Obesity and Osteoarthritis Awaiting Arthroplasty: A Randomised Trial

IF 2 4区医学 Q2 NURSING

International Journal of Nursing Practice Pub Date : 2025-08-21 DOI:10.1111/ijn.70044

Ladan Sahafi, David Smith, Ruurd Jaarsma, Malcolm Battersby

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引用次数: 0

Abstract

Background

Obesity is a risk factor for osteoarthritis and total hip/knee joint replacement and can lead to poorer outcomes following surgical interventions.

Aim

This work aimed to determine the preliminary efficacy of a self-management programme versus usual care in improving health-related quality of life in obese patients with osteoarthritis awaiting joint replacement.

Methods

This was a two-group parallel randomised trial involving patients with obesity and osteoarthritis who were awaiting hip or knee arthroplasty. Patients were randomly allocated to the Flinders Program of self-management support plus usual care or usual care alone groups. Primary outcomes at 10 months were Short-Form Health Survey (SF-36) and Osteoarthritis of Knee/Hip Quality of Life (OAKHQoL).

Results

Ninety-five patients were randomised to either intervention (n = 48) or usual care (n = 47) and analysed in an intent-to-treat analysis. While there was no intervention effect in SF-36, evidence was in favour of intervention for OAKQoL improved social support (d = 0.43, 95% CI: 0.01–0.83) versus usual care (d = −0.01, 95% CI: −0.41 to 0.42) (p = 0.03). Similarly, intervention patients experienced larger improvements for social activity (d = 0.47; 95% CI: 0.05–0.89) versus usual care (d = −0.16; 95% CI: −0.58 to 0.25) (p = 0.005).

Conclusion

The intervention warrants examination in a larger trial to establish effectiveness among patients with obesity and osteoarthritis awaiting arthroplasty.

Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12615000674538

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一项随机试验：自我管理方案对改善等待关节置换术的肥胖和骨关节炎患者生活质量的初步疗效

肥胖是骨关节炎和全髋关节/膝关节置换术的危险因素，可导致手术干预后的预后较差。目的：本研究旨在确定自我管理方案与常规护理在改善等待关节置换术的肥胖骨关节炎患者健康相关生活质量方面的初步疗效。方法：这是一项两组平行随机试验，涉及等待髋关节或膝关节置换术的肥胖和骨关节炎患者。患者被随机分配到弗林德斯自我管理支持计划加常规护理组或单独常规护理组。10个月时的主要结局是短期健康调查（SF-36）和膝关节/髋关节骨关节炎生活质量（OAKHQoL）。95例患者被随机分配到干预组（n = 48）或常规护理组（n = 47），并进行意向治疗分析。虽然SF-36没有干预效果，但有证据表明，与常规护理相比，OAKQoL的干预改善了社会支持（d = 0.43, 95% CI: 0.01 - 0.83）（d = - 0.01, 95% CI: - 0.41 - 0.42）（p = 0.03）。同样，与常规护理（d = - 0.16; 95% CI: - 0.58至0.25）相比，干预患者在社交活动方面有更大的改善（d = 0.47; 95% CI: 0.05-0.89）（p = 0.005）。结论：该干预措施值得在更大规模的试验中进行检验，以确定肥胖症和骨关节炎患者等待关节置换术的有效性。试验注册：澳大利亚新西兰临床试验注册中心ACTRN12615000674538

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来源期刊

International Journal of Nursing Practice NURSING-

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

3 months

期刊介绍： International Journal of Nursing Practice is a fully refereed journal that publishes original scholarly work that advances the international understanding and development of nursing, both as a profession and as an academic discipline. The Journal focuses on research papers and professional discussion papers that have a sound scientific, theoretical or philosophical base. Preference is given to high-quality papers written in a way that renders them accessible to a wide audience without compromising quality. The primary criteria for acceptance are excellence, relevance and clarity. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.