J Rheum Dis.  2016 Apr;23(2):109-117. 10.4078/jrd.2016.23.2.109.

Impact of Patient Education on the Satisfaction of Rheumatoid Arthritis Patients: A Randomized Trial of Nurse-led Versus Medical Docter-led Education

• Cho SK
• Kim D
• Choi J
• Lee S
• Bae GE
• Kim HK
• Yoo D
• Sung YK

• KMID: 2222787
• DOI: http://doi.org/10.4078/jrd.2016.23.2.109

Abstract

OBJECTIVE
To examine the impact of patient education (PE) on patients' satisfaction in rheumatoid arthritis (RA) and to compare nurse-led education with medical doctor (MD)-led education.
METHODS
Patients were enrolled by categorizing in two groups, nurse-led and MD-led education, randomization was performed. Face-to-face education was conducted two times, and changes in patient satisfaction before and after PE were assessed using the visual analogue scale (VAS; 0 to100 mm) and patients' satisfaction questionnaire (PSQ). Changes in patients' reported outcomes (PRO) were measured using disease activity score with 28 joint-erythrocyte sedimentation rate (DAS28-ESR), health assessment questionnaire (HAQ), and European quality of life-5 dimension (EQ-5D). Changes in patients' satisfaction and PRO between before and after PE were compared using paired t-test, and the comparison between nurse-led and MD-led education was analyzed using independent t-test.
RESULTS
A total of 120 patients, 60 patients from each group, were randomized to receive either nurse-led or MD-led education. Among them, 113 patients completely received education and final assessment. In total patients, patients' satisfaction was significantly increased from 87.8±13.1 mm to 92.3±8.8 mm in VAS (p<0.01), and from 3.7±0.4 to 4.0±0.4 in PSQ (p<0.01). There was no improvement in DAS28-ESR, HAQ, but there was mild improvement in quality of life (QOL) after PE. Improvement of patients' satisfaction by PSQ after nurse-led education was 0.4±0.4 and it was higher than 0.3±0.5 after MD-led education, but it was not statistically different (p=0.25).
CONCLUSION
PE for RA patients improved patients' satisfaction and QOL. Nurse-led education showed comparable improvement in patients' satisfaction with MD-led education.

Keyword

Rheumatoid arthritis; Patient education; Patient satisfaction

MeSH Terms

Arthritis, Rheumatoid*
Education*
Humans
Patient Education as Topic*
Patient Satisfaction
Quality of Life
Random Allocation

Figure

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  Figure 1. The flow of patient selection, randomization and follow-up. MD: medical doctor, RA: rheumatoid arthritis.

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  Figure 2. The change of patients' satisfaction and disease outcomes before and after education. (A) Change in patients' satisfaction with VAS before and after education. (B) Change in patients' satisfaction with PSQ before and after education. PSQ: patients' satisfaction questionnaire, VAS: visual analogue scale.

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