Review: group interventions may improve coping, quality of life, and social support in patients with arthritic conditions, but more research is needed

摘要

Arthritic conditions can pose difficult coping issues for patients. These diseases are chronic and progressive. They share the characteristics of pain, changes in function, and changes in qualify of life. These characteristics require patients to develop coping strategies to successfully deal with limitations imposed by the disease processes.Using a rigorous methodology, Savelkoul et al reviewed controlled studies that focused on group interventions for people with arthritic diseases (eg, rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis). Only 14 studies met the inclusion criteria. The methodological quality of the selected studies, as measured by the authors' criteria, was not high, but may actually be higher because in all studies, information on >=1 methodological criterion was not provided. Only 1 of 3 studies that measured coping reported improved coping after a group self management intervention. This is not unexpected because developing or enhancing coping strategies was not the expressed purpose of any of the studies.Several important clinical implications can be drawn from this work, The authors point out that evidence exists that active coping (compared with passive coping) is associated with less pain and depression. Thus, nrofessionals should have a key role in enhancing or modifying coping strategies for people living with rheumatoid arthritis or osteoarthritis. Rheumatoid arthritis is a chronic, systemic illness that can affect almost all aspects of a person's life. Most characteristic is a profound fatigue that can be unpredictable. Patients with osteoarthritis must learn to cope with the limitations imposed by joint pain. In both conditions, coping can be difficult. More information is needed on which interventions are effective in modifying coping strategies of patients with arthritic diseases.