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Rheumatology Advance Access published online on November 26, 2008
Rheumatology, doi:10.1093/rheumatology/ken429
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

An 8-yr follow-up of Arthritis Self-Management Programme participants

J. Barlow1, A. Turner1, L. Swaby1, M. Gilchrist1, C. Wright2 and M. Doherty3

1Self-Management Programme, Applied Research Centre in Health and Lifestyle Interventions, Faculty of Health and Life Sciences, Coventry University, Coventry, 2School of Health Sciences, University of Birmingham, Birmingham and 3Academic Rheumatology, University of Nottingham, City Hospital, Nottingham, UK

Correspondence to: J. Barlow, Self-Management Programme, Applied Research Centre in Health and Lifestyle Interventions, Faculty of Health and Life Sciences, Coventry University, Whitefriars Building, Priory Street, Coventry CV1 5FB, UK. E-mail: j.barlow{at}coventry.ac.uk


  Abstract

Objectives. To examine the pattern of scores on self-efficacy, health status and use of self-management techniques among a group of Arthritis Self-Management Programme (ASMP) participants over an 8-yr period, and to describe participants' perspectives of the ASMP and current use of self-management.

Methods. Data from 125 participants who attended the ASMP as part of a randomized controlled trial and completed assessments at baseline, 4-month and 8-yr follow-ups were entered into the analysis. A sub-sample of 10 participants (five high- and five low self-efficacy) was interviewed.

Results. The sample was 87% female; mean age 65 (S.D. 12) yrs; mean disease duration 19 (S.D. 11) yrs; 48% RA; 48% OA. The overall pattern of scores showed improvements between baseline and 4 months, which appeared to be maintained at 8-yr follow-up on self-efficacy, positive and negative affect, anxious and depressed moods, pain and fatigue, cognitive symptom management and communication with physician. The exception was HAQ, which was stable from baseline to 4 months (as expected), but had increased at 8 yrs indicating a decline in physical functioning. Sub-group analyses by RA and OA showed similar patterns of results. Interviews revealed that some participants continued to have problems with disease acceptance and highlighted the importance of pre-course expectations.

Conclusions. Long-term maintenance of self-efficacy, psychological well-being and self-management techniques may be possible following attendance on the ASMP. The need for additional psychological support for those who are having difficulty adjusting to their condition and its consequences is highlighted.

KEY WORDS: Arthritis, Self-efficacy, Self-management, Psycho-educational intervention

Submitted 9 May 2008; revised version accepted 9 October 2008.
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