Rheumatoid arthritis - Psychological interventions in RA

10 important questions on Rheumatoid arthritis - Psychological interventions in RA

What does research indicate on the effectiveness of psychological interventions on biopsychosocial outcomes?

  • Small improvements in functional disability, pain, fatigue and anxiety, depression
  • Moderate improvement in coping, SE, physical activity
  • Depression, coping and physical activity effects maintained at follow-up.

Which characteristics of an psychological intervention for RA patients improve effectiveness?

- long-term interventions
- interventions with a maintenance component.

What is in general the effectiveness of CBT health and wellbeing outcomes in RA patients?

  • Sign. Positive effect on anxiety, depression and fatigue
  • non-sign. Positive effect on pain
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What elements can psychological interventions for RA patients target?

  1. RA symptoms:  pain/fatigue
  2. Psychological problems: anxiety, fear, worry, depression
  3. Behavioural elements: physical inactivity, overactivity, medication adherence, weight loss

What are the most used psychological interventions?

  • CBT
  • Psycho-educational programs
  • Self-management

Which two educational focuspoints do psycho-educational programs have?

  1. Education on the progressive/unpredictable nature of RA
  2. The need to remain physical active

What strategies and skills do psycho-educational programs for RA patients often focus on?

  • Monitor and recognize symptom flair ups
  • informed decision making about distribution of energy across daily activities
  • goal setting, feed-back monitoring

What is in general the effectiveness of psycho-educational programs?

Significant effects on physical functioning & SE, not on anxiety, depression and pain.

What are the focus points of self-management programs for RA patients?

  1. Emphasize importance of cooperative care between patients and providers
  2. Self-management: improve patients own ability to manage his disease
  3. Disease information, medication/physical activity management, communication skills, problem solving skills

What is the Arthritis Self-management Program (ASMP) exists?

Psycho-educational group intervention, aimed at helping patients manage their condition and increase their confidence and control.
6 weeks, 2-2,5 hour sesions.
Topics:
  • managing physical / psychological effects
  • exercising and medication use
  • communication
  • maintaining healthy nutrition and sleep
  • making informed treatment decisions
  • problem solving  

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