환자 교육이 류마티스관절염 환자의 만족도에 미치는 영향: 교육 시행자에 따른 무작위 임상 시험

Abstract

Objective. To examine the impact of patient education (PE) on patients’ satisfaction in rheumatoid arthritis (RA) and to compare nurse-led education with medical doctor (MD)-led education. Methods. Patients were enrolled by categorizing in two groups, nurse-led and MD-led education, randomization was performed. Face-to-face education was conducted two times, and changes in patient satisfaction before and after PE were assessed using the visual analogue scale (VAS; 0 to100 mm) and patients’ satisfaction questionnaire (PSQ). Changes in patients’ reported outcomes (PRO) were measured using disease activity score with 28 joint-erythrocyte sedimentation rate (DAS28-ESR), health assessment questionnaire (HAQ), and European quality of life-5 dimension (EQ-5D). Changes in patients’ satisfaction and PRO between before and after PE were compared using paired t-test, and the comparison between nurse-led and MD-led education was analyzed using independent t-test. Results. A total of 120 patients, 60 patients from each group, were randomized to receive either nurse-led or MD-led education. Among them, 113 patients completely received education and final assessment. In total patients, patients’ satisfaction was significantly increased from 87.8±13.1 mm to 92.3±8.8 mm in VAS (p＜0.01), and from 3.7±0.4 to 4.0±0.4 in PSQ (p＜0.01). There was no improvement in DAS28-ESR, HAQ, but there was mild improvement in quality of life (QOL) after PE. Improvement of patients’ satisfaction by PSQ after nurse-led education was 0.4±0.4 and it was higher than 0.3±0.5 after MD-led education, but it was not statistically different (p=0.25). Conclusion. PE for RA patients improved patients’ satisfaction and QOL. Nurse-led education showed comparable improvement in patients’ satisfaction with MD-led education. (J Rheum Dis 2016;23:109-117)