Nurse counseling improves pain, fatigue, and function in rheumatoid arthritis patients in small RCT
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Key Takeaway
Consider nurse counseling for RA symptom management, but note evidence is from a single, small trial.
This randomized controlled trial enrolled 90 patients with rheumatoid arthritis from a university hospital rheumatology outpatient clinic in southern Turkey. Participants were randomized to receive either education based on the Theory of Planned Behavior plus three months of telephone nursing counseling (n=45) or routine follow-up (n=45). A total of 82 patients completed the three-month follow-up assessments.
Compared to routine care, the intervention group showed statistically significant improvements in several secondary outcomes. Post-intervention pain scores were 11.49 ± 6.76 (p = .001), fatigue scores were 19.63 ± 11.39 (p = .001), and functional status scores were 0.82 ± 0.44 (p = .001). The study did not report specific effect sizes or baseline scores for direct comparison of the magnitude of change.
Safety and tolerability data were not reported. Eight patients did not complete the study, but reasons for discontinuation were not specified. Key limitations include the single-center design, small sample size, and lack of reported primary outcome, effect sizes, and safety profile. The absence of funding and conflict of interest information further limits interpretation.
While the RCT design supports causal inference, the findings should be interpreted cautiously. The intervention shows promise for symptom management in RA, but its practice relevance is currently restrained to the specific cultural and healthcare context of the study setting. Larger, multi-center trials with comprehensive safety monitoring and clearly defined primary outcomes are needed before broader clinical application can be recommended.
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View Original Abstract ↓
BACKGROUND: Recent advancements in the treatment of rheumatological diseases have been significant. However, patients with rheumatoid arthritis (RA) continue to struggle with symptom management. Given the critical role of nursing in providing personalized care, integrating theoretical frameworks can be highly beneficial. These frameworks allow nurses to effectively guide patients' health behaviors and improve their self-management skills.
AIM: The aim of this study was to investigate the effects of nursing counseling based on the Theory of Planned Behavior on pain, fatigue, and functional status in RA patients.
DESIGN: This is a randomized controlled trial.
METHOD: Between January and July 2022, a randomized controlled trial was conducted at a university hospital's rheumatology outpatient clinic in southern Turkey. The study included 90 RA patients (45 in the intervention group and 45 in the control group). However, 82 patients completed the study. The intervention group received education based on the Theory of Planned Behavior and three months of telephone nursing counseling. The control group received routine follow-up. The study included pre-test, post-test, and three-month follow-up assessments.
RESULTS: After analyzing the data, significant improvements were found in the pain (11.49 ± 6.76) fatigue (19.63 ± 11.39), and functional status (0.82 ± 0.44) of patients in the intervention group (p = .001). Compared to the control group, Theory of planned behavior-based nursing counseling was found to have positive effects on these parameters. Additionally, it was reported that the intervention group patients showed improved adherence to treatment and better overall health status.
CONCLUSIONS: Nurse counseling based on the Theory of Planned Behavior has been found effective in improving pain, fatigue, and functional status management, as well as adaptation to the disease in patients with rheumatoid arthritis.
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