Enhanced self-efficacy after a self-management programme in pituitary disease: a randomized controlled trial

摘要

Context Patients with pituitary disease report impairments in Quality of Life (QoL) despite optimal biomedical care. Until now, the effects of a self-management intervention (SMI) addressing psychological and social issues for these patients and their partners have not been studied. Objective To examine the effects of a SMI i.e. Patient and Partner Education Programme for Pituitary disease (PPEP-Pituitary). Design and subjects A multicentre randomized controlled trial included 174 patients with pituitary disease, and 63 partners were allocated to either PPEP-Pituitary or a control group. PPEP-Pituitary included eight weekly sessions (90?min). Self-efficacy, bother and needs for support, illness perceptions, coping and QoL were assessed before the intervention (T0), directly after (T1) and after six months (T2). Mood was assessed before and after each session. Results Patients in PPEP-Pituitary reported improved mood after each session (except for session 1). In partners, mood only improved after the last three sessions. Patients reported higher self-efficacy at T1 ( P ?=?0.016) which persisted up to T2 ( P ?=?0.033), and less bother by mood problems directly after PPEP-Pituitary ( P ?=?0.01), but more bother after six months ( P ?=?0.001), although this increase was not different from baseline ( P ?=?0.346). Partners in PPEP-Pituitary reported more vitality ( P ?=?0.008) which persisted up to T2 ( P ?=?0.034). At T2, partners also reported less anxiety and depressive symptoms ( P ?≤?0.014). Conclusion This first study evaluating the effects of a SMI targeting psychosocial issues in patients with pituitary disease and their partners demonstrated promising positive results. Future research should focus on the refinement and implementation of this SMI into clinical practice.