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The Role of Social Reinforcement in the Maintenance of Short-Term Effects after a Self-Management Intervention for Frail Housebound Seniors with Arthritis*

Published online by Cambridge University Press:  09 May 2012

Sophie Laforest ,
Kareen Nour ,
Monique A.M. Gignac ,
Lise Gauvin  and
Manon Parisien
Sophie Laforest*
Affiliation:
Department of Kinesiology, University of Montréal Institut de recherche en santé publique de l’Université de Montréal (IRSPUM) Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire
Kareen Nour
Affiliation:
Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire Direction de santé publique de la Montérégie
Monique A.M. Gignac
Affiliation:
Health Care and Outcomes Research, University Health Network Dalla Lana School of Public Health, University of Toronto
Lise Gauvin
Affiliation:
Department of Social and Preventive Medicine, University of Montréal CRCHUM-Centre de recherche du Centre Hospitalier de l’Université de Montréal
Manon Parisien
Affiliation:
Centre for Research and Expertise in Social Gerontology (CRESG), CSSS Cavendish-Centre affilié universitaire
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Sophie Laforest, Ph.D. Department of Kinesiology Université de Montréal P.O. Box 6128 Downtown Station Montréal, QC H3C 3J7 (sophie.laforest@umontreal.ca)
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Abstract

Following the program I’m Taking Charge of My Arthritis!, study participants reported fewer functional limitations, less helplessness, and better coping effectiveness than did controls. This study examined the maintenance of these effects and the role of social reinforcement in maintaining benefits eight months post-intervention. The study collected information (1) at baseline (n=125); (2) two months later, before randomization (pre-intervention); (3) two months post-randomization (post-intervention 1); and (4) ten months post-randomization (post-intervention 2) (n=80). We conducted a randomized controlled trial comparing three groups: a control group, intervention group without social reinforcement, and intervention group with social reinforcement after the program. A multilevel analysis revealed that intervention participants with social reinforcement following the program continued to report significantly fewer functional limitations and greater coping effectiveness compared to intervention group participants without social reinforcement. This research provides preliminary evidence for the value of additional contact with frail housebound seniors post-intervention for maintaining the intervention benefits.

Résumé

Une étude a montré que le programme Mon arthrite, je m’en charge! pouvait réduire la perception des limitations fonctionnelles des participants du groupe expérimental, réduire leur sentiment d’impuissance et améliorer leur perception de gestion de la maladie. La présente étude examine le maintien de ces bénéfices et le rôle du renforcement social sur ce maintien, huit mois après l’intervention. Les mesures ont été prises à quatre temps: 1) mesure de base (n=125); 2) deux mois plus tard, avant randomisation (pré-intervention); 3) deux mois post randomisation (post-intervention) et 4) dix mois après la randomisation (post-intervention 2) (n=80). Un devis expérimental randomisé a été utilisé pour comparer trois groupes: le groupe témoin, le groupe expérimental sans renforcement social et le groupe expérimental avec renforcement social post-intervention (i.e., téléphones mensuels par un bénévole). Les analyses multiniveaux ont révélé que les participants du groupe expérimental avec renforcement social ont continué à rapporter moins de limitations fonctionnelles (p= 0.05) et une meilleure perception de gestion de la maladie (p=0.07) que les participants du groupe expérimental sans renforcement social. Cette étude fournit des preuves préliminaires sur la valeur ajoutée des renforcements post-intervention pour maintenir les effets d’un programme d’autogestion chez des aînés frêles, confinés à domicile.

Keywords

autogestionarthriteinterventionaînes frèlesl’entretien des effetsself-managementarthritisinterventionfrail older adultsmaintenance of effects
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 2 , June 2012 , pp. 195 - 207
Copyright
Copyright © Canadian Association on Gerontology 2012

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Footnotes

*

This research was funded by the Canadian Health Institute of Research Grant #MOP-42547. We thank the study’s participants, Richard Goudreault of the Direction de santé publique de Montréal, collaborating at local Community Health Services Centers CLSCs, and members of the Advisory Committee for their contributions to this research.

KN and SL jointly conceptualized the research project, participated in the design of the study and wrote the article. KN further developed the ideas and the statistical analysis and coordinated the gathering of data. SL, as principal researcher of the project I’m Taking Charge of My Arthritis!, undertook the project’s general supervision and actively participated in each step. LG primarily guided the statistical analysis and contributed to the write-up of the manuscript. MG was involved in the original design of the research and made a significant contribution to writing of the article, through a critical review of the intellectual content. MP made a significant contribution to writing of the article and supervised the program offering. All authors read and approved the final manuscript.

References

Allen, K., Oddone, E., Coffman, C., Datta, S., Juntilla, K., Lindquist, J., et al. . (2010). Telephone-based self-management of osteoarthritis, a randomized trial. Annals of Internal Medicine, 153(9), 570–579.CrossRefGoogle ScholarPubMed
Astin, J.A., Beckner, W., Soeken, K., Hochberg, M.C.C., & Berman, B. (2002). Psychological interventions for rheumatoid arthritis: A meta-analysis of randomized controlled trials. Arthritis and Rheumatism, 47(3), 291–302.CrossRefGoogle ScholarPubMed
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215.CrossRefGoogle Scholar
Barlow, J., Turner, A., Swaby, L., Gilchrist, M., Wright, C., & Doherty, M. (2009). An 8-year follow-up of arthritis self-management programme participants. Rheumatology, 48, 128–133.CrossRefGoogle Scholar
Bellamy, N., Watson, H., Buchanan, W., Goldsmith, C.H., Campbell, J., & Stitt, L.W. (1988). Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcome to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. Journal of Rheumatology, 15, 1833–1840.Google ScholarPubMed
Bennett, J.A., Perrin, N.A., Hanson, G., Bennett, D., Gaynor, W., Flaherty-Robb, M., et al. . (2005). Healthy aging demonstration project: Nurse coaching for behavior change in older adults. Research in Nursing & Health, 28, 187–197.CrossRefGoogle ScholarPubMed
Blalock, S.J., DeVellis, R.F., Brown, G.K., & Wallston, K.A. (1989). Validity of the center for epidemiological studies depression scale in arthritis population. Arthritis and Rheumatology, 32(8), 991–997.CrossRefGoogle Scholar
Buszewicz, M., Rait, G., Griffin, M., Nazareth, I., Patel, A., Atkinson, A., et al. . (2006). Self management of arthritis in primary care: Randomised controlled trial. British Medical Journal, 333(7574), 879.CrossRefGoogle ScholarPubMed
Callahan, L.F., Mielenz, T., Freburger, J., Shreffler, J., Hootman, J., Brady, T., et al. . (2008). A randomized controlled trial of the people with arthritis can exercise program: Symptoms, function, physical activity, and psychosocial outcomes. Arthritis and Rheumatism, 59(1), 92–101.CrossRefGoogle ScholarPubMed
Castro, C.M., King, A.C., & Brassington, G.S. (2001). Telephone versus mail intervention for maintenance of physical activity in older adults. Health Psychology, 20(6), 438–444.CrossRefGoogle ScholarPubMed
Choquette, D., Bellamy, N., & Raynauld, J.P. (1994). A French-Canadian version of the WOMAC osteoarthritis index. Arthritis and Rheumatism, 37, S226.Google Scholar
Collier, A.C., Ribaudo, H., Mukherjee, A.L., Feinberg, J., Fischl, M.A., & Chesney, M. (2005). A randomized study of serial telephone call support to increase adherence and thereby improve virologic outcome in persons initiating antiretroviral therapy. The Journal of Infectious Diseases, 192(8), 1398–1406.Google Scholar
Dale, J., Caramlau, I.O., Lindenmeyer, A., & Williams, S.M. (2009). Peer support telephone calls for improving health (Review). The Cochrane Database of Systematic Reviews Library, 4(1), 1–44.Google Scholar
Daveluy, C., Pica, L., Audet, N., Courtemanche, R., Lapointe, F., Côté, L. & Baulne, J. (2001). Enquête sociale et de santé 1998—Cahier technique et méthodologique: Documentation générale, Volume 1. Montréal, Institut de la statistique du Québec,Google Scholar
Dennis, C.L. (2003) Peer support within a health care context: A concept analysis. International Journal of Nursing studies, 40, 321–332.CrossRefGoogle ScholarPubMed
DeVellis, R.F., & Callahan, L.F. (1993). A brief measure of helplessness in rheumatic disease: The helplessness subscale of the rheumatology attitudes index. The Journal of Rheumatology, 20, 866–869.Google ScholarPubMed
Duruoz, M.T., Poiraudeau, S., Fermanian, J., Menkes, C.J., Amor, B., Dougados, M., et al. . (1996). Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. The Journal of Rheumatology, 23(7), 1167–1172.Google ScholarPubMed
Eakin, E., Lawler, S., Vandelanotte, C., & Owen, N. (2007). Telephone interventions for physical activity and dietary behavior change. A systematic review. American Journal of Preventive Medicine, 32(5), 419–434.CrossRefGoogle ScholarPubMed
Freeman, K., Hammond, A., & Lincoln, N.B. (2002). Use of cognitive behavioural arthritis education programmes in newly diagnosed rheumatoid arthritis. Clinical Rehabilitation, 16, 828–836.CrossRefGoogle ScholarPubMed
Fuhrer, R., & Rouillon, F. (1989). La version française de l’échelle CES-D (Center for Epidemiologic Studies-Depression Scale). Description et traduction de l’échelle d’auto-évaluation. Psychiatrie et Psychobiologie, 4, 163–166.CrossRefGoogle Scholar
Gignac, M.A.M. (2000). An evaluation of a psychotherapeutic group intervention for persons having difficulty coping with musculoskeletal disorders. Social Work in Health Care, 32(1), 57–75.CrossRefGoogle ScholarPubMed
Goeppinger, J., Armstrong, B., Schwartz, T., Ensley, D., & Brady, T.J. (2007). Self-management education for persons with arthritis: Managing comorbidity and eliminating health disparities. Arthritis and Rheumatism, 57(6), 1081–1088.CrossRefGoogle ScholarPubMed
Goodman, S. (1998). Multiple comparisons, explained. American Journal of Epidemiology, 147(9), 807–812.CrossRefGoogle ScholarPubMed
Health Canada. (2010). Life with Arthritis in Canada: A personal and public health challenge. Retrieved fromhttp://www.phac-aspc.gc.ca/cd-mc/arthritis-arthrite/lwaic-vaaac-10/index-eng.php.Google Scholar
Horvath, A.O., Del Re, A.C., Fluckiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16.CrossRefGoogle ScholarPubMed
Hughes, S.L., Seymour, R.B., Campbell, R.T., Huber, G., Pollak, N., Sharma, L., et al. . (2006). Long-term impact of fit and strong! on older adults with osteoarthritis. The Gerontologist, 46(6), 801–814.Google Scholar
Iversen, M.D., Hammond, A., & Betteridge, N. (2010). Self-management of rheumatic diseases: State of the art and future perspectives. Annals of the Rheumatic Diseases, 69, 955–963.CrossRefGoogle ScholarPubMed
Jaarsma, T., Abu-Saad, H.H., Dracup, K., & Halfens, R. (2000). Self-care behavior of patients with heart failure. Scandinavian Journal of Caring Sciences, 14, 112–119.Google ScholarPubMed
Kolt, G.S., Schofield, G.M., Kerse, N., Garrett, N., & Oliver, M. (2007). Effect of telephone counseling on physical activity for low-active older people in primary care: A randomized, controlled trial. Journal of the American Geriatrics Society, 55, 986–992.CrossRefGoogle ScholarPubMed
Laforest, S., Nour, K., Parisien, M., Griskan, A., Poirier, M.C., & Gignac, M. (2008a). “I’m taking charge my arthritis”: Designing a targeted self-management program for frail seniors. Journal of Physical and Occupational Therapy in Geriatrics, 26(4), 45–66.CrossRefGoogle Scholar
Laforest, S., Nour, K., Parisien, M., Griskan, A., Poirier, M.C., & Gignac, M. (2008b). Short-term effects of a self-management intervention on health status of housebound older adults with arthritis. Journal of Applied Gerontology, 27(5), 539–567.CrossRefGoogle Scholar
Lindroth, Y., Brattstöm, M., Bellman, I., Ekestaf, G., Olofsson, Y., Strömbeck, B., et al. . (1997). A problem-based education program for patient with rheumatoid arthritis: Evaluation after three and twelve months. Arthritis care and Research, 10(5), 325–332.Google Scholar
Lineker, S.C., Bell, M.J., Wilkins, A.L., & Badley, E.M. (2001). Improvements following short term home based physical therapy are maintained at one year in people with moderate to severe rheumatoid arthritis. Journal of Rheumatology, 28, 165–168.Google ScholarPubMed
Lorig, K., & Holman, H. (1993). Arthritis self-management studies: A twelve years review. Health Education Quarterly, 20(1), 17–28.CrossRefGoogle Scholar
Lorig, K.R., Ritter, P.L., Laurent, D.D., & Plant, K. (2008). The internet-based arthritis self-management program: A one-year randomized trial for patients with arthritis or fibromyalgia. Arthritis and Rheumatism, 59(7), 1009–1017.CrossRefGoogle ScholarPubMed
Neugebauer, A., & Katz, P.P. (2004). Impact of social support on valued activity disability and depressive symptoms in patients with rheumatoid arthritis. Arthritis and Rheumatism, 51(4), 586–592.CrossRefGoogle ScholarPubMed
Nguyen, H.Q., Carrieri-Kohlman, V., Ranki, S.H., Slaughter, R., & Stulbarg, M.S. (2004). Internet-based patient education and support interventions: A review of evaluation studies and directions for future research. Computers in Biology and Medicine, 34, 95–112.CrossRefGoogle Scholar
Niedermann, K., Fransen, J., Knols, R., & Uebelhart, D. (2004). Gap between short- and long-term effects of patient education in rheumatoid arthritis patients: A systematic review. Arthritis and Rheumatism, 51(3), 388–398.CrossRefGoogle Scholar
Nour, K., Laflamme, V., Laforest, S., & Bouchard, L. (2005). Importance des exercices physiques et de la relaxation dans le cadre d’un programme d’autogestion des symptômes de l’arthrite. Vie et vieillissement, 4(3), 16–21.Google Scholar
Nour, K., Laforest, S., Gauvin, L., & Gignac, M. (2006). Behavior change following a self-management intervention for housebound older adults with arthritis: An experimental study. The International Journal of Behavioral Nutrition and Physical Activity, 3(12), 1–13.CrossRefGoogle ScholarPubMed
Nour, K., Laforest, S., Gignac, M., & Gauvin, L. (2007). Long-term maintenance of increases in exercise involvement following a self-management intervention for housebound older adults with arthritis. The International Journal of Nutritional Behavior and Physical Activity, 4(22), 1–8.Google ScholarPubMed
Pariser, D., O’Hanlon, A., & Espinoza, L. (2005). Effects of telephone intervention on arthritis self-efficacy, depression, pain, and fatigue in older adults with arthritis. Journal of Geriatric Physical Therapy, 28(3), 67–73.CrossRefGoogle ScholarPubMed
Parry, M., & Watt-Watson, J. (2010). Peer support intervention trials for individuals with heart disease: A systematic review. European Journal of Cardiovascular Nursing, 9, 57–67.CrossRefGoogle ScholarPubMed
Pernerger, T.V. (1998). What’s wrong with Bonferonni adjustments? British Medical Journal, 316, 1236–1238.CrossRefGoogle Scholar
Radloff, L.S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Reid, M.C., Papaleontiou, M., Ong, A., Breckman, R., Wethington, E., & Pilemer, K. (2008). Self-management strategies to reduce pain and improve function among older adults in community settings: A review of the evidence. Pain Medicine, 9(4), 409–424.CrossRefGoogle ScholarPubMed
Riemsma, R.P., Taal, E., & Rasker, J.J. (2003). Group education for patients with rheumatoid arthritis and their partners. Arthritis and Rheumatism, 49(4), 556–566.CrossRefGoogle ScholarPubMed
Sharpe, L., Sensky, T., Timberlake, N., Ryan, B., & Allard, S. (2003). Long-term efficacy of a cognitive behavioural treatment from a randomized controlled trial for patients recently diagnosed with rheumatoid arthritis. Rheumatology, 42(3), 435–441.Google Scholar
Shearer, N.B.C., Cisar, N., & Greenberg, E.A. (2007). A telephone-delivered empowerment intervention with patients diagnosed with heart failure. Heart & Lung, 36(3), 159–169.CrossRefGoogle ScholarPubMed
Wolfe, F. (1999). Determinants of WOMAC function, pain and stiffness scores: Evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthritis, rheumatoid arthritis and fibromyalgia. Rheumatology, 38(4), 355–361.CrossRefGoogle ScholarPubMed
Yip, Y.B., Sit, J.W., Fung, K.K.Y., Wong, D.Y.S., Chong, S.Y.C., Chung, L.H., et al. . (2007). Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study. Patient Education and Counseling, 65, 113–121.Google Scholar