A randomised controlled trial of lay-led self-management for people with multiple sclerosis
A randomised controlled trial of lay-led self-management for people with multiple sclerosis
复制标题
DOI：
10.1016/j.pec.2009.02.009
复制
发表时间：
2009-10-01
影响因子：
3.5
通讯作者：
Gilchrist, Mollie
中科院分区：
文献类型：
--
作者：
Barlow, Julie;Turner, Andy;Gilchrist, Mollie
目的：探讨慢性疾病自我管理课程（CDSMC）对多发性硬化症（MS）患者的影响。方法：两组随机对照试验，干预组（IG）和等候名单对照组（WLCG）。从选择不参加CDSMC的对照组（CC）收集额外数据。参与者完成基线问卷；IG参加者立即出席CDSMC；所有参与者在4个月和12个月时进行评估。结果：共回收基线问卷216份；73%为女性，平均年龄51.1岁，平均病程12.0年。结果显示，CDSMC对自我管理自我效能感（IG组的ES 0.30, p = 0.009）和MSIS身体状况（IG组的ES 0.12, p = 0.005）有影响。没有其他统计学上显著的变化。然而，抑郁症（IG组的ES 0.21, p = 0.05）和MS自我效能感（IG组的ES 0.16, p = 0.04）的改善趋势被注意到。所有的改善在12个月后保持不变。在基线时，与RCT参与者相比，CG参与者年龄更大，病程更长（p < 0.01），焦虑程度更低（p = 0.009）。结论：CDSMC对ms患者有一定的积极作用，参加的动机可能与心理困扰和病程有关。实践启示：CDSMC可能对那些需要额外支持的轻度焦虑/抑郁患者有价值。建议在病程早期出诊。2009爱思唯尔爱尔兰有限公司版权所有。
Objective: To determine the impact of the Chronic Disease Self-Management Course (CDSMC) on people with multiple sclerosis (MS).Methods: 2-group, randomised, controlled trial with Intervention Group (IG) and Waiting-List Control Group (WLCG). Additional data were collected from a Comparison Group (CC) who chose not to attend the CDSMC. Participants completed baseline questionnaires; IG participants attended the CDSMC immediately; all participants were assessed at 4-months and 12-months.Results: 216 baseline questionnaires were returned; 73% were female, mean age 51.1 years, mean disease duration 12.0 years. Results showed that the CDSMC had an impact on self-management self-efficacy (ES 0.30, p = 0.009 for the IG) and MSIS physical status (ES 0.12 for the IG, p = 0.005). There were no other statistically significant changes. However, trends towards improvement on depression (ES 0.21 for the IG, p = 0.05) and MS self-efficacy (ES 0.16 for the IG, p = 0.04) were noted. All improvements were maintained at 12-months. At baseline, CG participants were older, had longer disease duration (p < 0.01) and less anxiety (p = 0.009) compared to RCT participants.Conclusion: The CDSMC provides some small positive effects for people with MS. Motivation to attend may be linked to psychological distress and disease duration.Practice implications: The CDSMC may be of value for those with mild anxiety/depression who need extra support. Attendance early in the disease course is recommended. (C) 2009 Elsevier Ireland Ltd. All rights reserved.