PDF(Pubmed)
Abstract：
BACKGROUND: Despite continuous improvements in anti-rheumatic pharmacological treatment, people with chronic inflammatory arthritis still report substantial disease impact. Based on the framework for complex interventions, we thus developed INSELMA, a novel nurse-coordinated multidisciplinary self-management intervention for patients with rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. Based on individual biopsychosocial assessments, a rheumatology nurse facilitated goal setting and coordinated interdisciplinary support. The aim of this study was to explore the patients\' experience of participating in the six-months INSELMA intervention.
METHODS: Individual semi-structured interviews were conducted with 15 of the participants after their final follow-up. Thematic analysis was applied.
RESULTS: The analysis derived four overall themes. (1) A new opportunity at the right time. The participants\' disease impacted all areas of daily life. Participation in INSELMA was experienced as an opportunity to improve symptoms and together reduce long-held challenges they had fought alone, until now. (2) The importance of person-centred goals. The participants found it meaningful to work with their individual goals, which encompassed physical, psychological, and social factors. Having time between consultations to work with goals at home was important. (3) Empathy, partnership and a little nudging from health professionals are essential. The empathic nurses\' continuous support and coaching helped participants become aware of their own resources. The participants highlighted having access to support from a physiotherapist and occupational therapist with rheumatology experience as important. (4) I got more than I could have hoped for. Most of the participants experienced decreased symptom load and improvement in physical strength, mobility, sleep, and mood as well as increased energy, knowledge, and self-management ability. The participants expressed new hope for the future with an improved ability to manage their symptoms and work towards new goals.
CONCLUSIONS: The participants found the INSELMA intervention meaningful and feasible. They experienced decreased disease impact and increased activity levels, facilitated by empathy and self-management support from health professionals.
METHODS: Individual semi-structured interviews were conducted with 15 of the participants after their final follow-up. Thematic analysis was applied.
RESULTS: The analysis derived four overall themes. (1) A new opportunity at the right time. The participants\' disease impacted all areas of daily life. Participation in INSELMA was experienced as an opportunity to improve symptoms and together reduce long-held challenges they had fought alone, until now. (2) The importance of person-centred goals. The participants found it meaningful to work with their individual goals, which encompassed physical, psychological, and social factors. Having time between consultations to work with goals at home was important. (3) Empathy, partnership and a little nudging from health professionals are essential. The empathic nurses\' continuous support and coaching helped participants become aware of their own resources. The participants highlighted having access to support from a physiotherapist and occupational therapist with rheumatology experience as important. (4) I got more than I could have hoped for. Most of the participants experienced decreased symptom load and improvement in physical strength, mobility, sleep, and mood as well as increased energy, knowledge, and self-management ability. The participants expressed new hope for the future with an improved ability to manage their symptoms and work towards new goals.
CONCLUSIONS: The participants found the INSELMA intervention meaningful and feasible. They experienced decreased disease impact and increased activity levels, facilitated by empathy and self-management support from health professionals.
摘要：
背景：尽管抗风湿药物治疗不断改善，慢性炎症性关节炎患者仍报告有重大疾病影响。基于复杂干预的框架，因此，我们开发了INSELMA，一种新的护士协调的多学科自我管理干预类风湿关节炎患者，银屑病关节炎或轴性脊柱关节炎。根据个人的生物心理社会评估，风湿病护士促进了目标设定和协调的跨学科支持。本研究的目的是探讨患者参与6个月INSELMA干预的经验。
方法：在最后一次随访后，对15名参与者进行了个人半结构化访谈。采用了专题分析。
结果：分析得出四个总体主题。（1）在适当的时间出现新的机会。参与者的疾病影响了日常生活的各个领域。参加INSELMA是一个改善症状并共同减少他们独自战斗的长期挑战的机会，直到现在.（2）以人为本目标的重要性。参与者发现与他们的个人目标一起工作是有意义的，其中包括物理，心理,和社会因素。在协商之间有时间在家里实现目标很重要。（3）同理心，伙伴关系和卫生专业人员的一点推动是至关重要的。共情护士的持续支持和指导帮助参与者意识到他们自己的资源。参与者强调，获得物理治疗师和具有风湿病经验的职业治疗师的支持很重要。（4）我得到的比我所希望的要多。大多数参与者经历了症状负荷下降和体力改善，移动性,睡眠,和情绪以及增加的能量，知识,和自我管理能力。参与者表达了对未来的新希望，提高了管理症状和实现新目标的能力。
结论：参与者发现INSELMA干预有意义且可行。他们经历了减少的疾病影响和增加的活动水平，由卫生专业人员的同理心和自我管理支持促进。
方法：在最后一次随访后，对15名参与者进行了个人半结构化访谈。采用了专题分析。
结果：分析得出四个总体主题。（1）在适当的时间出现新的机会。参与者的疾病影响了日常生活的各个领域。参加INSELMA是一个改善症状并共同减少他们独自战斗的长期挑战的机会，直到现在.（2）以人为本目标的重要性。参与者发现与他们的个人目标一起工作是有意义的，其中包括物理，心理,和社会因素。在协商之间有时间在家里实现目标很重要。（3）同理心，伙伴关系和卫生专业人员的一点推动是至关重要的。共情护士的持续支持和指导帮助参与者意识到他们自己的资源。参与者强调，获得物理治疗师和具有风湿病经验的职业治疗师的支持很重要。（4）我得到的比我所希望的要多。大多数参与者经历了症状负荷下降和体力改善，移动性,睡眠,和情绪以及增加的能量，知识,和自我管理能力。参与者表达了对未来的新希望，提高了管理症状和实现新目标的能力。
结论：参与者发现INSELMA干预有意义且可行。他们经历了减少的疾病影响和增加的活动水平，由卫生专业人员的同理心和自我管理支持促进。
