Sharing, caring and learning to take control: Self-management training for people with arthritis

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Abstract
Community-based health interventions have been shown to be effective in promoting self-management amongst people with arthritis in the USA, but have rarely been evaluated in a UK context. The aim of this study was to determine the effectiveness of self-management training among people with arthritis against the backdrop of the UK system of health care. The study was a multiple baseline, pre-test post-test design of 117 people attending Arthritis Self-Management Programmes (ASMP) delivered in community settings on a nationwide basis. Data were collected by self-administered questionnaires at two points in time: prior to the ASMP and after the ASMP, four months from baseline. The sample comprised 81% women, with a mean age of 59 and mean disease duration of 14.5 years. Most participants had either rheumatoid arthritis (RA) or osteoarthritis (OA). Results showed that after four months, participants demonstrated significant increases in arthritis self-efficacy (p < 0.0005), cognitive symptom management (p < 0.0005), communication with doctors (p = 0.001), use of flexibility exercises (p = 0.0001), strengthening exercises (p = 0.0008) and relaxation (p < 0.00005). In addition, significant decreases were found in terms of pain (p = 0.002), fatigue (p = 0.002) and anxiety (p = 0.002). A trend towards improvement on depression and disease acceptance was noted. The results suggest that group interventions for people with arthritis can enhance perceived control of arthritis, can encourage the use of cognitive-behavioural techniques, help to reduce symptoms of pain and fatigue, and can improve psychological wellbeing.