Ladan Sahafi, David Smith, Ruurd Jaarsma, Malcolm Battersby
{"title":"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","authors":"Ladan Sahafi, David Smith, Ruurd Jaarsma, Malcolm Battersby","doi":"10.1111/ijn.70044","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Obesity is a risk factor for osteoarthritis and total hip/knee joint replacement and can lead to poorer outcomes following surgical interventions.</p>\n </section>\n \n <section>\n \n <h3> Aim</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Ninety-five patients were randomised to either intervention (<i>n</i> = 48) or usual care (<i>n</i> = 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 (<i>d</i> = 0.43, 95% CI: 0.01–0.83) versus usual care (<i>d</i> = −0.01, 95% CI: −0.41 to 0.42) (<i>p</i> = 0.03). Similarly, intervention patients experienced larger improvements for social activity (<i>d</i> = 0.47; 95% CI: 0.05–0.89) versus usual care (<i>d</i> = −0.16; 95% CI: −0.58 to 0.25) (<i>p</i> = 0.005).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The intervention warrants examination in a larger trial to establish effectiveness among patients with obesity and osteoarthritis awaiting arthroplasty.</p>\n \n <p><b>Trial Registration:</b> Australian New Zealand Clinical Trials Registry ACTRN12615000674538</p>\n </section>\n </div>","PeriodicalId":14223,"journal":{"name":"International Journal of Nursing Practice","volume":"31 4","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ijn.70044","citationCount":"0","resultStr":"{\"title\":\"Preliminary Efficacy of a Self-Management Programme to Improve Quality-of-Life in Patients With Obesity and Osteoarthritis Awaiting Arthroplasty: A Randomised Trial\",\"authors\":\"Ladan Sahafi, David Smith, Ruurd Jaarsma, Malcolm Battersby\",\"doi\":\"10.1111/ijn.70044\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Obesity is a risk factor for osteoarthritis and total hip/knee joint replacement and can lead to poorer outcomes following surgical interventions.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Aim</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Ninety-five patients were randomised to either intervention (<i>n</i> = 48) or usual care (<i>n</i> = 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 (<i>d</i> = 0.43, 95% CI: 0.01–0.83) versus usual care (<i>d</i> = −0.01, 95% CI: −0.41 to 0.42) (<i>p</i> = 0.03). 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Preliminary Efficacy of a Self-Management Programme to Improve Quality-of-Life in Patients With Obesity and Osteoarthritis Awaiting Arthroplasty: A Randomised Trial
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
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.
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