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Zhou J, Gan Y, Fan X, Qi H, Cao Y, Luo Z. Latent class analysis of psychological resilience and influencing factors in patients with rheumatoid arthritis: a cross-sectional survey. Clin Rheumatol 2024; 43:1803-1813. [PMID: 38594463 DOI: 10.1007/s10067-024-06959-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES To investigate the latent class of psychological resilience in patients with rheumatoid arthritis (RA) and examine the factors influencing various latent types. METHODS A cross-sectional survey design was used in this study. A total of 480 patients with RA were enrolled from two tertiary care institutions in Chengdu, Sichuan Province, between May and November 2023, using the convenience sample approach. The General Information Questionnaire, CD-RISC-10, SSRS, ASES-8, and BRAF-MDQ were used to analyze the latent classes of psychological resilience in the respondents, and the factors influencing the latent classes were explored using one-way analysis of variance, analysis of variance, and multi-categorical logistic regression analysis. RESULTS Overall, 423 valid questionnaires were returned, indicating an 88.13% effective return rate. A latent class analysis revealed that RA patients were divided into three classes of psychological resilience: low-level (20.3%), moderate-level (31.0%), and high-level (48.7%) psychological resilience. A multi-categorical logistic regression analysis found that social support, self-efficacy, weariness, age, work status, and somatic pain all significantly influenced psychological resilience in RA patients. CONCLUSION Three classes of RA patients' psychological resilience were identified by this study, and these classes were strongly correlated with individual treatment components. It is crucial to take into account the psychological resiliency of female RA patients who do not have a job. In order to improve psychological resilience, healthcare staff should first increase their comprehension of treat-to-target. Furthermore, people with RA may become more psychologically resilient if they receive more social support. Key Points • Preliminary research found that psychological resilience in RA patients was associated with three latent classes. • In RA patients, psychological resilience was significantly influenced by self-efficacy, fatigue, age, work status, physical pain, and social support. • The fundamental goal of bolstering RA patients' psychological resilience is to reaffirm their place in the treatment process, for example, by improving patient compliance and achieving treat-to-target earlier.
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Affiliation(s)
- Jian Zhou
- Department of Orthopedics, School of Clinical Medicine & The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Yuqin Gan
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Xinxin Fan
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Hong Qi
- Department of Orthopedics, School of Clinical Medicine & The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Yuqiong Cao
- Department of Rheumatology and Immunology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
| | - Zongting Luo
- Department of Nursing, The Third People's Hospital of Chengdu & The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
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Zhang W, Ji H, Wu Y, Sun K, Li J, Xu Z, Wang C, Zhao F, Sun Q. Patient Self-Management Scale After Total Knee Arthroplasty (PSMS-TKA): Instrument Development and Cross-Sectional Validation Study. J Arthroplasty 2024:S0883-5403(24)00554-0. [PMID: 38830430 DOI: 10.1016/j.arth.2024.05.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Effective self-management after total knee arthroplasty (TKA) not only improves patients' knee pain and physical function but also improves quality of life. However, there is no assessment tool that can be targeted to evaluate the self-management level of patients after TKA. This study aimed to develop and validate a scale to specifically assess the level of self-management in patients after TKA. METHODS The study was conducted in 2 steps: (1) instrument development and (2) psychological tests (n = 428). For the instrument development portion, scale items were generated through a literature review and semi-structured interviews, then reviewed and revised by a panel of experts, and assessed for content validity and pilot testing. For the psychometric tests component, items were analyzed using corrected item-total scale correlations, the critical ratio method, and Cronbach's α. Construct validity was evaluated using exploratory factor analysis and validation factor analysis. Criterion correlation validity was checked by calculating Pearson's correlation coefficient using the Arthritis Self-Efficacy Scale-8 and the scale developed in this study. Internal consistency reliability was evaluated using Cronbach's α and fold-half reliability, and retest reliability was assessed using intragroup correlation coefficients. RESULTS The Patient Self-Management Scale after Total Knee Arthroplasty (PSMS-TKA) comprises 4 factors and 23 items that assess daily behavior management, disease information management, psychosocial management, and exercise rehabilitation management. Exploratory factor analysis and validation factor analysis yielded a stable 4-factor model for the 23 items. The PSMS-TKA demonstrated good criterion-related validity when using the Arthritis Self-Efficacy-8 as a criterion. The Cronbach's α of the PSMS-TKA was 0.903, the split-half reliability was 0.934, and the test-retest reliability correlation coefficient was 0.887 (P < .01); thus, the reliability of the scale is good. CONCLUSIONS The PSMS-TKA developed in this study has good validity and reliability and can be used to assess the level of self-management in patients after TKA. The scale helps healthcare professionals understand the level of self-management of patients undergoing TKA.
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Affiliation(s)
- Wenzhong Zhang
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Hong Ji
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yan Wu
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Kangming Sun
- Nursing Department, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Jing Li
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Zhenzhen Xu
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Chunlei Wang
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Fengyi Zhao
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
| | - Qingxiang Sun
- Shandong University of Traditional Chinese Medicine School of Nursing, Jinan, China
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Gong G, Dong A, Zhang Z, Mao J. Medication adherence and predictive factors among patients with rheumatoid arthritis: A COM-B model guided structural equation modeling analysis. PATIENT EDUCATION AND COUNSELING 2024; 119:108080. [PMID: 37995488 DOI: 10.1016/j.pec.2023.108080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To assess medication adherence of patients with rheumatoid arthritis (RA) and explore predictive factors under the guidance of the Capability, Opportunity and Motivation to Behavior (COM-B) model. METHODS A cross-sectional study was conducted among 221 RA patients conveniently recruited from rheumatology outpatient clinics of a university-affiliated hospital in China. Data about patients' sociodemographic and disease characteristics, medication adherence, functional disability, social support, beliefs about medicines, self-efficacy, and depression were collected via self-administered questionnaires. The influence of factors within the COM-B model on medication adherence were analyzed by the structural equation model. RESULTS The mean score of medication adherence was 63.19 (SD 8.83), and 214 participants (96.8%) were considered non-adherent to their medication regime. Greater functional disability, higher social support, more positive beliefs about medicines, higher self-efficacy, and lower depression were significantly positively associated directly or indirectly with medication adherence, explaining 66% of the total variance. CONCLUSION Patients with RA demonstrate poor medication adherence. Essentials in improving medication adherence are delaying the occurrence of disability, promoting social support, shaping beliefs about medicines, enhancing self-efficacy, and relieving depression. PRACTICE IMPLICATIONS The value of integrated interventions targeting the drivers and barriers to medication adherence identified in this study should be further explored.
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Affiliation(s)
- Guilan Gong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anhong Dong
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Puer Emergency Medical Rescue Center, Puer, China
| | - Zeyu Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Institute for Hospital Management, Tsinghua University, Beijing, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Goff AJ, Jones LE, Lim CJ, Tan BY. A cross sectional study exploring the relationship of self-reported physical activity with function, kinesiophobia, self-efficacy and quality of life in an Asian population seeking care for knee osteoarthritis. BMC Musculoskelet Disord 2024; 25:74. [PMID: 38238654 PMCID: PMC10795260 DOI: 10.1186/s12891-024-07181-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Physical activity is a guideline-recommended first-line intervention for people with knee osteoarthritis. Physical activity levels, and its potential correlates, is underexplored in Asian populations with knee osteoarthritis. METHODS Participants enrolled in a longitudinal study in Singapore self-reported physical activity (UCLA activity score), function (Knee Osteoarthritis Outcome Score [KOOS-12]), kinesiophobia (Brief fear of movement [BFOM]), self-efficacy (ASES-8), and quality of life (EQ-5D-5 L). One-Way ANOVA was used to test the difference in outcomes between UCLA categories, while ordinal logistic regression was used to identify the associated factors to physical activity level. RESULTS Seventy-three percent of all enrolled participants (n = 311/425) reported either inactivity or low physical activity (median 4, IQR 3-5). Significant, weak, positive correlations were observed be-tween UCLA activity score and either KOOS-12 (Spearman's rho: 0.1961; p < 0.001), ASES-8 (0.1983; p = 0.004), or EQ-5D-5 L (0.2078; p < 0.001). A significant, weak, negative correlation was observed between physical activity and BFOM (-0.2183; p < 0.001). Significant differences in function between groups (moderate vs. inactive or low physical activity) were not clinically important. Participants with obesity, from the eldest age category (i.e. ≥75), or who identified as Malay or female, were less physically active than those with a healthy BMI, below the age of 54, or who identified as Chinese or male, respectively. CONCLUSION Healthcare professionals in Asia should be aware of the large proportion of people with knee osteoarthritis who are either inactive or have low physical activity levels. Screening for, and offering interventions to promote, physical activity and its correlates should be prioritised.
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Affiliation(s)
- Anthony J Goff
- Singapore Institute of Technology, Health and Social Sciences, 10 Dover Drive, Singapore, 138683, Singapore
| | - Lester E Jones
- Singapore Institute of Technology, Health and Social Sciences, 10 Dover Drive, Singapore, 138683, Singapore
- Judith Lumley Centre, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora, Vic, 3086, Australia
| | - Chien Joo Lim
- Orthopaedic Surgery, Woodlands Health, Yishun Community Hospital, 2 Yishun Central 2 Tower E, Singapore, 768024, Singapore
| | - Bryan Yijia Tan
- Orthopaedic Surgery, Woodlands Health, Yishun Community Hospital, 2 Yishun Central 2 Tower E, Singapore, 768024, Singapore.
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Zimba O, Gasparyan AY. Designing, Conducting, and Reporting Survey Studies: A Primer for Researchers. J Korean Med Sci 2023; 38:e403. [PMID: 38084027 PMCID: PMC10713437 DOI: 10.3346/jkms.2023.38.e403] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Survey studies have become instrumental in contributing to the evidence accumulation in rapidly developing medical disciplines such as medical education, public health, and nursing. The global medical community has seen an upsurge of surveys covering the experience and perceptions of health specialists, patients, and public representatives in the peri-pandemic coronavirus disease 2019 period. Currently, surveys can play a central role in increasing research activities in non-mainstream science countries where limited research funding and other barriers hinder science growth. Planning surveys starts with overviewing related reviews and other publications which may help to design questionnaires with comprehensive coverage of all related points. The validity and reliability of questionnaires rely on input from experts and potential responders who may suggest pertinent revisions to prepare forms with attractive designs, easily understandable questions, and correctly ordered points that appeal to target respondents. Currently available numerous online platforms such as Google Forms and Survey Monkey enable moderating online surveys and collecting responses from a large number of responders. Online surveys benefit from disseminating questionnaires via social media and other online platforms which facilitate the survey internationalization and participation of large groups of responders. Survey reporting can be arranged in line with related recommendations and reporting standards all of which have their strengths and limitations. The current article overviews available recommendations and presents pointers on designing, conducting, and reporting surveys.
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Affiliation(s)
- Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
| | - Armen Yuri Gasparyan
- Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK
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Uritani D, Kubo T, Yasuura Y, Fujii T. Reliability and validity of the Japanese short-form arthritis self-efficacy scale in patients with knee osteoarthritis: A cross-sectional study. PLoS One 2023; 18:e0292426. [PMID: 37862299 PMCID: PMC10588891 DOI: 10.1371/journal.pone.0292426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/20/2023] [Indexed: 10/22/2023] Open
Abstract
Self-efficacy is the belief that one can perform a specific behavior or task in the future, and it has been associated with physical and psychological aspects in people with chronic musculoskeletal disorders. The self-efficacy of individuals with arthritis can be assessed using the Arthritis Self-Efficacy Scale. The 8-item Short-Form ASES (ASES-8) has been employed in recent times. However, the reliability and validity of the Japanese ASES-8 (ASES-8J) have not been investigated. Therefore, this study aimed to investigate the reliability and validity of the ASES-8J. Overall, 179 Japanese participants with knee osteoarthritis (OA) were enrolled. Cronbach's alpha was calculated to confirm internal validity. Intraclass correlation coefficients (ICCs) were used to estimate test-retest reliability. Construct validity was analyzed using the Pain Self-Efficacy Questionnaire (PSEQ) and the problem-solving and positive thinking subscales of Brief Coping Orientation to Problems Experienced (Brief COPE). Discriminant validity was analyzed by comparing "worse" and "better" groups based on pain severity; short-form version of Depression, Anxiety, and Stress Scale-21 (DASS-21); Brief Fear of Movement Scale for Osteoarthritis (BFOMSO); Pain Catastrophizing Scale (PCS); and physical function subscale of Western Ontario and McMaster Arthritis Index. Cronbach's alpha and ICC were 0.94 and 0.81, respectively. Correlation coefficients among ASES-8J, PSEQ, and Brief COPE problem-solving and positive thinking subscales were 0.42, 0.43, and 0.32, respectively. Regarding the depression and stress subscales of DASS-21, BFOMSO, and PCS, the worse group showed significantly lower ASES-8J scores than the better group. Coefficients of correlation among ASES-8J, PSEQ, and the problem-solving and positive thinking subscales of Brief COPE were low to moderate. These findings suggest that the ASES-8J is a valid and reliable tool for assessing self-efficacy in Japanese patients with knee OA and can facilitate comparisons of arthritis self-efficacy between Japanese patients and non-Japanese patients.
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Affiliation(s)
- Daisuke Uritani
- Faculty of Health Science, Department of Physical Therapy, Kio University, Kitakasturagigun, Nara, Japan
| | - Takanari Kubo
- Department of Physical Therapy, Osaka Kawasaki Rehabilitation University, Kaizuka, city, Osaka, Japan
| | - Yuuka Yasuura
- Department of Rehabilitation, Shimada Hospital, Habikino city, Osaka, Japan
| | - Tadashi Fujii
- Department of Orthopaedic Surgery, Kashiba Asahigaoka Hospital, Kashiba city, Nara, Japan
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Christakou Α, Fijalkowska ΜΕ, Lazari E, Georgoudis G. Translation, validation, and reliability of the Greek version of the Arthritis Self-Efficacy Scale. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2023. [DOI: 10.1080/21679169.2023.2164939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Αnna Christakou
- Department of Physiotherapy, University of Peloponnese, Corinth, Greece
| | - Μalwina-Εufemia Fijalkowska
- Research Laboratory of Musculoskeletal Physiotherapy, Department of Physiotherapy, University of West Attica, Athens, Greece
| | - Eirini Lazari
- Research Laboratory of Musculoskeletal Physiotherapy, Department of Physiotherapy, University of West Attica, Athens, Greece
| | - Georgios Georgoudis
- Research Laboratory of Musculoskeletal Physiotherapy, Department of Physiotherapy, University of West Attica, Athens, Greece
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Song Y, Reifsnider E, Chen Y, Wang Y, Chen H. The Impact of a Theory-Based mHealth Intervention on Disease Knowledge, Self-efficacy, and Exercise Adherence Among Ankylosing Spondylitis Patients: Randomized Controlled Trial. J Med Internet Res 2022; 24:e38501. [PMID: 36264605 DOI: 10.2196/38501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/14/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patient education is recommended as an integral part of disease management in ankylosing spondylitis (AS), a chronic rheumatic disease that predominantly affects young males and requires long-term disease management. Convenient and cost-effective approaches to deliver patient education are required to these patients. OBJECTIVE This study aimed to examine the effects of a theory-based educational intervention delivered through a social networking app, WeChat, on disease knowledge, self-efficacy, exercise adherence, and health outcomes in Chinese AS patients. METHODS This study was a single-blind randomized controlled trial conducted in a tertiary hospital in Chengdu, China. Eligible participants were randomly allocated to the intervention or control group. Participants in the control group received standard care. The intervention group received the health belief model (HBM)-based educational intervention, consisting of 4 individual educational sessions and educational information sharing through WeChat, the predominant social networking app in China. The primary outcomes were disease knowledge, self-efficacy, and exercise adherence. The secondary outcomes were disease activity and physical function. Data were collected at baseline and at the end of the intervention (12th week). Chi-square test, t test, Mann-Whitney U tests were used to examine the effects of educational intervention. RESULTS This study included 118 patients with AS. The majority of participants were male (93/118, 78.8%). Around half of them were married (56/118, 47.5%), never smoked (70/118, 59.3%), and had college educational level or above (62/118, 52.5%). At posttest, participants in the intervention group had higher disease knowledge (all P<.001) and self-efficacy (P<.001), and a larger proportion of participants in the intervention group adhered to regular exercise routines than those in the control group (P=.003). The within-group analyses for the intervention group showed increases in all scores of disease knowledge (all P<.001) and self-efficacy score (P<.001), but only correct answer score (P=.04) and general knowledge score (P=.002) of disease knowledge in the control group improved. The within-group analysis for the control group found a decline of physical function (P=.002) but no significant change in disease activity (P>.05). The within-group analysis for the intervention group showed no significant change in disease activity or physical function (P>.05). At posttest, no statistically significant difference was found on disease activity or physical function between the intervention and control groups (P>.05). CONCLUSIONS The HBM-based educational intervention through WeChat can effectively improve patient disease knowledge, self-efficacy, and exercise adherence. WeChat is feasible and effective to deliver patient education for patients with chronic diseases such as AS. This mHealth intervention can be integrated into routine rheumatology care. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR-IPR-16009293; https://tinyurl.com/swxt8xk7.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Elizabeth Reifsnider
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
| | - Yanling Chen
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Ying Wang
- Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Chen
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Gao L, Sun Y, Pan L, Li Y, Yuan J, Cui X, Shi B. Current status and influencing factors of fatigue in patients with rheumatoid arthritis: A cross-sectional study in China. Int J Nurs Pract 2021; 28:e12996. [PMID: 34309127 DOI: 10.1111/ijn.12996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 02/08/2020] [Accepted: 06/17/2021] [Indexed: 10/20/2022]
Abstract
AIM This study aimed to explore the level and influencing factors of fatigue in patients with rheumatoid arthritis. METHODS This cross-sectional study was conducted in 243 patients with rheumatoid arthritis from April 2016 to March 2017. The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Arthritis Self-Efficacy Scale-8, Visual Analogue Scale for pain, physical function subscale of Short Form 36-Item Health Survey, Hospital Anxiety and Depression Scale, Perceived Social Support Scale, Pittsburgh Sleep Quality Index and a self-designed demographic and disease-related information questionnaire were used to collect the data. Stepwise linear multiple regression was used to clarify the impact of statistically significant variables (P < 0.05) in the independent sample t test, one-way ANOVA and correlation analysis on the level of fatigue. RESULTS Stepwise linear multiple regression analyses showed that disease activity, self-efficacy, physical function, pain, depression, duration of morning stiffness and anxiety were major factors influencing fatigue in patients with rheumatoid arthritis, which explained 59.5% of the total variance. CONCLUSION Our study demonstrated a moderate level of fatigue in Chinese patients with rheumatoid arthritis. In clinical practice, nurses should explore individualized intervention programmes based on related predictors of fatigue to help patients relieve fatigue.
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Affiliation(s)
- Lei Gao
- Department of Nursing, Huizhou First Hospital, Huizhou, China
| | - Yao Sun
- Department of Nursing, Tianjin Union Medical Center, Tianjin, China
| | - Li Pan
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Yafang Li
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Jiqing Yuan
- Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuejun Cui
- Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin, China
| | - Baoxin Shi
- School of Nursing, Tianjin Medical University, Tianjin, China
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Wang F, Zhang X, Tong X, Zhang M, Xing F, Yang K, Jiao N, Duan Z. The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study. BMC Musculoskelet Disord 2021; 22:313. [PMID: 33781238 PMCID: PMC8008642 DOI: 10.1186/s12891-021-04179-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 03/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA. METHODS A three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up. RESULTS One hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group. CONCLUSIONS CE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients. TRIAL REGISTRATION Chinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.
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Affiliation(s)
- Fenglan Wang
- School of Nursing, Shanxi Medical University, 56 Xinjian Road, Yingze District, Taiyuan, 030001 China
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Xiaoli Zhang
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Xiao Tong
- Department of Joint Surgery, The Second Hospital of Tangshan, 21 Jianshe Road, Lubei District, Tangshan, 063000 China
| | - Min Zhang
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Fengmei Xing
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Kun Yang
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Nana Jiao
- College of Nursing and Rehabilitation, North China University of Science and Technology, 21 Bohai Road, Caofeidian District, Tangshan, 063210 China
| | - Zhiguang Duan
- School of Nursing, Shanxi Medical University, 56 Xinjian Road, Yingze District, Taiyuan, 030001 China
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Hamilton CB, Li LC. Measures of Patient Activation and Self-Efficacy. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:645-659. [PMID: 33091240 DOI: 10.1002/acr.24350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Clayon B Hamilton
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Linda C Li
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
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Arab Alkabeya H, Daibes J, Hughes AM, Adams J. The Arabic Arthritis Self-Efficacy Scale-8 (ASES-8): a valid and reliable measure of evaluating self-efficacy in Palestinian patients with rheumatoid arthritis. Disabil Rehabil 2020; 43:3827-3833. [DOI: 10.1080/09638288.2020.1748730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Hisham Arab Alkabeya
- School of Health Sciences, Faculty of the Environment and Life Sciences, University of Southampton, Southampton, UK
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | - Jumana Daibes
- Faculty of Allied Medical Sciences, Arab American University, Jenin, Palestine
| | - Ann-Marie Hughes
- School of Health Sciences, Faculty of the Environment and Life Sciences, University of Southampton, Southampton, UK
| | - Jo Adams
- School of Health Sciences, Faculty of the Environment and Life Sciences, University of Southampton, Southampton, UK
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Liu Z, Gao L, Zhang W, Wang J, Liu R, Cao B. Effects of a 4‐week Omaha System transitional care programme on rheumatoid arthritis patients' self‐efficacy, health status, and readmission in mainland China: A randomized controlled trial. Int J Nurs Pract 2020; 26:e12817. [PMID: 31985129 DOI: 10.1111/ijn.12817] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 11/23/2019] [Accepted: 01/04/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Zhi‐Chen Liu
- Department of Nursing General Hospital of Western Command Theater Chengdu China
- School of Nursing Air Force Medical University Xi'an China
| | - Li Gao
- School of Nursing Air Force Medical University Xi'an China
| | - Wen‐Hao Zhang
- School of Nursing Air Force Medical University Xi'an China
- Department of Respiratory General Hospital of Tibet Military Region Lhasa China
| | - Jing Wang
- School of Nursing Air Force Medical University Xi'an China
| | - Rong‐Rong Liu
- School of Nursing Air Force Medical University Xi'an China
| | - Bao‐Hua Cao
- School of Nursing Air Force Medical University Xi'an China
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14
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Jackson T, Xu T, Jia X. Arthritis self-efficacy beliefs and functioning among osteoarthritis and rheumatoid arthritis patients: a meta-analytic review. Rheumatology (Oxford) 2019; 59:948-958. [DOI: 10.1093/rheumatology/kez219] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/25/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
The Arthritis Self-Efficacy Scale (ASES) is a widely used self-report measure of beliefs reflecting confidence in one’s capacity to function despite pain and control pain or other symptoms of arthritis. Despite evidence linking higher ASES scores to lower levels of impairment, pain and emotional distress, numerous modest, non-significant associations have also been observed. In this meta-analysis, we evaluated overall associations between ASES scores and adjustment in RA and OA samples as well as potential moderators that may explain the heterogeneity in these associations.
Method
Data from 48 samples that met all 10 inclusion criteria (N = 9222 patients) were subject to analyses.
Results
ASES scores had significant medium average effect sizes with functional impairment, pain severity and emotional distress but substantial heterogeneity was evident for each association. ASES–impairment associations were moderated by the diagnosis, ASES version and ASES subscale content: significantly larger effect sizes were found for studies that included RA patients, used the original 20-item ASES and assessed subscale content reflecting the pursuit of daily activities despite pain (i.e. functional self-efficacy) than for studies based exclusively on OA patients, the eight-item ASES and ASES pain control and other symptom subscales. Relations of ASES scores with pain severity and emotional distress were moderated by ASES version and subscale content, respectively.
Conclusion
The ASES has significant overall associations with key areas of functioning. Moderator analyses of the measure provide empirically grounded suggestions for optimal use of the ASES within OA and RA patient samples.
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Affiliation(s)
- Todd Jackson
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
- Department of Psychology, University of Macau, Taipa, Macau, S.A.R., China
| | - Ting Xu
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
| | - Xiaojun Jia
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
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15
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da Silva RVT, Silva FDC, Meireles SM, Natour J. Translation to Brazilian Portuguese, cultural adaptation and psychometric properties of 8-item ArthritisSelf-Efficacy Scale (ASES-8). SAO PAULO MED J 2019; 137:6-12. [PMID: 31116272 PMCID: PMC9721212 DOI: 10.1590/1516-3180.2018.0354071218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 12/07/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Self-efficacy refers to one's belief in one's ability to organize, perform actions and face challenges in order to achieve goals and motivation. High self-efficacy improves disease coping and adherence to treatment among patients with rheumatoid arthritis. The objective of this study was to translate, culturally adapt and test the reproducibility of the 8-item Arthritis Self-Efficacy Scale (ASES-8) questionnaire for use in Brazil. DESIGN AND SETTING Validation study conducted in university outpatient clinics. METHODS The questionnaire was translated into Brazilian Portuguese and then back-translated into English. The final version in Portuguese was tested on 30 patients with rheumatoid arthritis and was shown to be understandable and culturally adapted. A further 32 patients with rheumatoid arthritis were evaluated three times using the questionnaire. On the first occasion, two evaluators applied the questionnaire to check inter-evaluator reproducibility. After 15 days, one of the evaluators reassessed the patients to verify intra-evaluator reproducibility. At the first assessment, to test the construct validity of ASES-8, the Numerical Pain Scale, Health Assessment Questionnaire, Beck Depression Inventory and Short Form-36 questionnaire were also applied to all the patients. RESULTS The inter and intra-evaluator correlation coefficients for ASES-8 were high. Cronbach's alpha was higher than 0.90 for the questionnaire, indicating excellent internal consistency. There were moderate correlations between ASES-8 and most of the instruments tested, indicating good construct validity. CONCLUSION ASES-8 was translated and adapted to the Portuguese language for Brazil. This instrument is valid, reproducible and reliable for evaluating self-efficacy among patients with rheumatoid arthritis.
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Affiliation(s)
| | - Fabiana de Carvalho Silva
- PT, MSc. Doctoral Student, Rheumatology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Sandra Mara Meireles
- PT, PhD. Physiotherapist, Rheumatology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
| | - Jamil Natour
- MD, PhD. Associate Professor, Rheumatology Division, Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil.
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16
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Zhao X, Cao F, Liu Q, Li X, Xu G, Liu G, Zhang Y, Yang X, Yi S, Xu F, Fan K, Ma J. Behavioral, inflammatory and neurochemical disturbances in LPS and UCMS-induced mouse models of depression. Behav Brain Res 2019; 364:494-502. [DOI: 10.1016/j.bbr.2017.05.064] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 05/21/2017] [Accepted: 05/26/2017] [Indexed: 01/03/2023]
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17
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Madecassoside impedes invasion of rheumatoid fibroblast-like synoviocyte from adjuvant arthritis rats via inhibition of NF-κB-mediated matrix metalloproteinase-13 expression. Chin J Nat Med 2018; 16:330-338. [PMID: 29860993 DOI: 10.1016/s1875-5364(18)30064-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Indexed: 12/25/2022]
Abstract
Fibroblast-like synoviocytes (FLS) play a pivotal role in Rheumatoid arthritis (RA) pathogenesis through aggressive migration and invasion. Madecassoside (Madec), a triterpenoid saponin present in Centella asiatica herbs, has a potent anti-inflammatory effect. In the present study, Madec exerted an obvious therapeutic effect in reversing the histological lesions in adjuvant-induced arthritis (AIA) rats. To recognize the anti-rheumatoid potentials of Madec, we further investigated whether Madec interfered with FLS invasion and metalloproteinase (MMP) expression. In cultures of primary FLS isolated from the AIA rats, Madec (10 and 30 μmol·L-1) was proven to considerably inhibit migration and invasion of FLS induced by interleukin 1β (IL-1β), but exhibiting no obvious effect on cell proliferation. Madec repressed IL-1β-triggered FLS invasion by prohibiting the expression of MMP-13. Additionally, Madec suppressed MMP-13 transcription via inhibiting the MMP-13 promoter-binding activity of NF-κB. Our results further showed that Madec down-regulated the translocation and phosphorylation of NF-κB as demonstrated by Western blotting and immunofluorescence assays. In conclusion, our results suggest that Madec exerts anti-RA activity via inhibiting the NF-κB/MMP-13 pathway.
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Fu X, Li ZJ, Yang CJ, Feng L, Sun L, Yao Y, Huang YT. The prevalence of depression in rheumatoid arthritis in China: A systematic review. Oncotarget 2017; 8:53623-53630. [PMID: 28881836 PMCID: PMC5581135 DOI: 10.18632/oncotarget.17323] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/20/2017] [Indexed: 12/30/2022] Open
Abstract
This systematic review is to explore the prevalence of depression in patients with rheumatoid arthritis (RA) in China. Articles of prevalence rates for depression in adult RA patients published before October 2015 were identified from PubMed, Embase, The Cochrane Library, CNKI, CBM, VIP, and Wanfang database and other internet databases. Relevant journals and the recommendations of expert panels were also searched manually. Two independent reviewers searched and assessed the literature. Therelevant data were applied with Meta-Analyst 3.13 software, and the forest plot and funnel plot were performed. 21 studies with a total of 4447 patients were selected to be enrolled in this study. The prevalence of depression by analyzing the effect size was 48% [95% CI (41%, 56%)]. The prevalence of minor depression and dysthymic disorder was 30% [95%CI (23%, 38%)], and the moderate or major depression was 18% [95%CI (11%, 29%)], respectively. Subgroup analysis showed that the depression rate of female RA patients was higher than male. The depression rate in the central and western areas were higher than that of the eastern region of China, the prevalence level estimated by the Geriatric Depression Scale (GDS) was higher than estimated by other tools. Sensitivity analysis showed that the pooled effect size had good stability and reliability, To be conclusive, the prevalence rate of depression in RA patients is 48%, which suggesting that medical staff should pay more attention to depression in adult patients with RA.
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Affiliation(s)
- Xin Fu
- Department of Orthopaedics, Tianjin Hospital, Tianjin, China
| | - Zhi-Jun Li
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Chun-Jun Yang
- Department of Nursing, Tianjin Medical University General Hospital, Tianjin, China
| | - Liangshu Feng
- Department of Neurology and Neuroscience Center, First Hospital of Jilin University, Changchun, China
| | - Lemeng Sun
- Cancer Center, First Hospital of Jilin University, Changchun, China
| | - Yang Yao
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu-Ting Huang
- Children's Research Institute, Children's National Medical Center, Washington, DC, USA
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