自我管理方案在膝关节骨关节炎患者中应用的效果研究

The impact of a self-management program on quality of life in knee osteoarthritis patients

目的探讨自我管理方案对膝关节骨关节炎患者生活质量的影响。方法 2013年2月至2014年2月,纳入膝关节骨关节炎患者200例,随机分为试验组和对照组各100例,对照组给予常规护理,试验组在常规护理基础上实施膝关节骨性关节炎自我管理方案,干预时间为4周。分别于干预前、干预结束时、干预结束4周后随访时应用简明健康调查量表(Short-Form-36 Health Survey,SF-36)、西安大略和麦克马斯特大学骨关节炎指数评定量表(The Western Ontario and Mc Master Universities Osteoarthritis Index,WOMAC)躯体功能分量表评估两组患者生活质量和关节功能障碍。结果重复测量方差分析结果显示,干预结束时、干预结束4周后随访时,试验组总体健康得分高于对照组,差异有统计学意义(P<0.05);SF-36心理领域各条目得分时间效应均有统计学意义(P<0.05);两组WOMAC躯体功能分量表得分变化时间效应和组间效应均无统计学意义(P>0.05)。结论实施膝关节骨关节炎自我管理方案改善了患者总体健康,尚需进一步探讨更有效的自我管理方案和康复锻炼方式。

Objective To evaluate the effectiveness of a four-week Knee Osteoarthritis Self-Management Program（KOASMP） on the elderly who suffered from knee osteoarthritis（KOA）. Methods From February 2013 to February2014,200 patients with KOA were recruited and divided into two groups. The 100 participants in the experimental group received a four-week KAP program and 100 participants in the control group received routine care. The main outcome measures included quality of life（QOL） and disability level,which were assessed by Short-Form-36 Health Survey（SF-36） and the Western Ontario and Mc Master Universities（WOMAC）,respectively,and were repeatedly measured at baseline,at the end of the intervention,and four weeks after the intervention. Results Repeated measures analysis of variance showed that significant difference of changes was found in scores of general health between the groups（P〈0.05） and there was no difference in disability level（P〉0.05）. Conclusion Knee Osteoarthritis Self-Management Program（KOASMP） can improve the general health of patients with KOA,and more effective self-management program and exercise method in KOA need to be provided.