The title of the research was Rheumatoid Arthritis Patient Education and Self-Efficacy. The main objective of this research was to describe the prevailing rheumatoid arthritis patient education offered by specialized rheumatology health care professional including nurse in the various healthcare settings in Finland. It achieves this aim by describing the level of knowledge rheumatoid patient have about the disease, treatment regime and what various types of self-efficacy care they employed in addition to the educational interventions. The major goal of this research is the applicability of the results achieved. The main goals identified included helping develop and improve patient education with people affected with rheumatoid arthritis. Moreover, it can also be utilized in nursing training programs to better the contents of the curriculum and additional courses in rheumatologic specialized nursing.
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Patient education is an important health promotion tool comprising a multi-level learning system. Patient accessibility to information regarding arthritis rheumatoid has mostly been through patient education program. The main aim and priority of rheumatoid arthritis education is to help patients improve self-care by increasing knowledge levels and to take absolute control of their health behaviors. After the provision of requisite information, the researchers expects people suffering arthritis rheumatoid would exhibit efficient assessment and monitoring qualities in determining the progress of the disease and appropriately manage it (Schrieber & Colley 2004).
The multi-professional team in caring for arthritis rheumatoid is numerous and each has a role to play during the process. For instance the physician or medical doctor makes the medical diagnosis, in charge of prescribing medications and manages the rheumatoid patient’s medical treatment and follow up care. The nurses in the multi-professional team play a crucial part in the education and health promotion in the lives of the rheumatoid arthritis patients. Their role is also to educate patients by advising and assist with concerns in managing their medication. They also offer nursing support, evaluates the well-being of the clients and offer emotional support for improved compliance to care and treatment plan. The pharmacist supplies the medication upon the orders of the physician or medical. They also have the duty to analyze patient’s other medication. In maintaining the musculoskeletal functions and ability by exercising with patients affected with arthritis rheumatoid is supported by the physiotherapist. They help patient with light training helping improve the joint movement and functions. They also recommend and support usage of support devices and appropriate sitting, lying and lifting up techniques. Physiotherapist employs physical therapy to facilitate reduction patients’ arthritis pain and preserve their functioning capabilities (Working group established by the Finnish Society for Rheumatology in 2003). The role of Occupational therapist is to help in maintaining the functional working abilities by giving directives which supports skeletal joint protection and saving energy. This helps arthritis patient to return to active work life. The role of the social worker in the life of the arthritis patient is confined to domestic, economic and social issues. They seek assistance to support arthritis rheumatoid patient at home for instance shopping, household work, and so on. The social worker is aware and makes available to the patients to all social amenities and support including type of social government support and to explain the social and fundamental rights of patient with arthritis rheumatoid. The emotional well-being and mental stability of arthritis rheumatoid patients is handled by the psychologist or psychologist nurse. They offer different coping mechanisms and strategies to people with arthritis to accept and adapt well to the disease.
According to Paula (2009), rheumatoid arthritis is defined as a progressive, long term, multi-systemic disease without known cause. It generally starts in smaller joint for instance joint in the hands and feet, then spread to bigger and larger joints usually resulting in disfigurement and physical disability. It causes pain, skeletal joint swelling, tiredness, malaise and morning stiffness. However, this may result in functional impairment and may lead to challenges at home and work The incidence rate in 2000 was 29people out of every 100000people was having rheumatoid arthritis in Finland, the trend decreased from the 1980 (Kaipiainen-Seppänen & Kautiainen 2006.). The prevalence increases with ageing especially in the older population. It is much higher in prevalence in women compared to men with a sex ratio of 2.5:1. This means within a given population there are approximately 3women more with the disease compared one male. Hormonal reasons may explain this trend but however it is however actual cause remains unclear.
There is no precise cure for rheumatoid arthritis and as a result patient needs to rely on regular treatment to relieve the pain and to correct deformities. The treatment thus is aimed at relieving symptoms of the disease and any physical changes induced by the disease. The treatment also helps to retard the progression of the disease using both medical and alternative forms of treatments. In the early years, gold and cortisone were employed as a medical form of treatments. Currently, non-steroidal anti-inflammatory medication and anti-rheumatic drugs in addition to gold and cortisone which helps to decrease inflammation and pain due to arthritis. When skeletal joints are significantly damaged the only medical procedure to repair is surgical treatments (Working group established by the Finnish Society for Rheumatology in 2003.).
There are several phase of life rheumatoid possess limitations. These include social functions and life, daily tasks and activities, physical contact (hugging, lifting, holding and so forth), personal and social relationships. The pain as a result of the arthritis may even cause to abandon activities such writing or scribbling, holding a book to read or even stand upright for a period of time (Whalley et al. 1997.).
The psychological or mental well-being of arthritis rheumatoid patient is basically about adapting or coping to the disease and controlling the stress as a result of it. Most arthritis patient described bad emotional characteristics such as anger, frustration, depression, shame, irritation, depression, sadness, guilt, anxiety and future uncertainty as their main threats. The cause of depression is more common in arthritis patient and has no specific cause. Self-respect and adapting to the disease is widely considered to be linked to their psychological well-being. The capability of the patient to cope with the symptoms in daily life activities are very critical and numerous coping mechanisms are employed to reduce the stress related to the disease.(Melanson & Downe-Wamboldt 2003.). One of the commonly used coping strategies was by spiritual or religious coping method which helped considerably in reducing joint pain, negative moods and increasing positive emotions (Keefe et al. 2001.).
Basically, in the research there were two main types of education for rheumatoid arthritis patients. They are the one-to-one and group education. In the one-to-one education it offers more flexibility. In addition, information and teaching is tailored out to fit an individual’s perceived needs. The patient also can influence the duration of teaching. One-to-one education maybe suitable for rheumatoid arthritis patients requiring individualized training or joint protection plans or information regarding new medication. On the contrary, group education facilitates social interaction and best for delivering information to groups of people or peers about general issues such as the disease development, treatments, exercise therapy, diet and so forth. One of the benefit of the group education could be some patients can be role models for others to learn from each other. Trust building and trusty atmosphere motivates patients to express their emotions and views about the disease and to enquire information (Kyngäs 2003, Haugli et al. 2004.).
According to Bandura (1977) defined:
‘Self-efficacy as a judgment of one’s ability to organize and execute given types of performances, whereas an outcome expectation is a judgment of the likely consequence such performances will produce’.
It is basically one’s ability and competence to complete a specific given task in order to achieve a specific goal. It basically places more emphasis on their capabilities or competencies but not concerned with the skills one possesses.
In conclusion, arthritis rheumatoid is a very serious disease and is a life-long progressive disease. Currently, no cure for it has been discovered yet but however treatment to relieve symptom is available. Education to equip patient with self-care is also recommended to complement the treatment care.
I learnt quite a great deal especially when it comes to the education and the role of the multiprofessional team in the care process. It was a great experience trying to review an article because I believe would be helpful also in my thesis.
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