Construction And Evaluation Of Oral Self-Health Management Training Program For Patients With Rheumatoid Arthritis And Periodontitis

Objective:1.The study aims to establish an oral self-health management training program suitable for Rheumatoid arthritis patients with periodontitis.2.The study aims to evaluate the effects of training program on oral health of rheumatoid arthritis patients with periodontitis as well as its influence on the disease activities are to be evaluated.Methods:1.The study adopts the method of literature analysis to compare,classify and summarize the literature to form the first draft of oral self-health management training program.11 experts in rheumatic immunity,oral,and clinical care,nursing education were invited to demonstrate the first draft and the author revise it according to experts’ opinions,so as to form an intervention plan.2.In a randomized controlled trial,we randomly divided 110 subjects from one provincial general hospital who were diagnosed as rheumatoid arthritis with periodontitis into the experimental group and the control group,55 subjects per group.The control group received routine nursing while the experimental group was included in the training program for 3 months besides the routine nursing.The patients’ self-care ability,oral health-related quality of life,periodontal index(probing depth,plaque index,clinical attachment loss,probing bleeding),RA related clinical indicators :ESR,number of tender joints,number of swollen joints and DAS 28 score were collected in order to analyze and evaluate the effects of the program on oral health and disease activities of rheumatoid arthritis.Results:1.Construction of oral self-health management program includes:(1)Baseline data collection;(2)Self-care theory and disease-related knowledge training;(3)Periodontal examination and periodontal cleaning performed by dentists;(4)Oral self-care skills training;(5)Daily diet guidance training;(6)Emotional support training;(7)Follow up after discharge.The manual of oral self-health management program was compiled by the methods of literature reviews and expert conferences.2.Effect evaluation of oral self-health management program.(1)Before the intervention,no significant differences were found in general information,self-care ability,oral health-related quality of life score,periodontal index,rheumatoid arthritis related clinical indicators and DAS28 score(P > 0.05),showing there is comparability of the two groups.(2)Before and after the intervention,the scores of patients’ self-care ability were as below:(1)Within the experimental group,the self-care ability after the intervention was better than that before the intervention,and the difference was statistically significant(P < 0.05);no remarkable difference was found in the control group(P >0.05).(2)Compared with the control group,the experimental group’s difference was more obvious(P < 0.05).(3)Before and after the intervention,the results of oral health-related quality of life scores were as below:(1)The experimental group score was lower than before,the difference was statistically significant(P<0.05);There was no significant difference in the control group(P>0.05).(2)The experimental group possessed statistically significant difference before and after intervention over the control group(P < 0.05).(4)Comparison of periodontal examination results between the two groups before and after the intervention:(1)Compared within the group,the plaque index,positive rate of probing bleeding,probing depth and clinical attachment loss of the experimental group after the intervention were better than those before the intervention,and the difference was remarkable(P< 0.05);In the control group,no remarkable differences were found(P > 0.05).(2)The difference before and after intervention of plaque index,positive rate of probing bleeding,probing depth and clinical attachment loss in the experimental group were better than those in the control group(P < 0.05).(5)The comparison of RA related clinical indexes between the two groups before and after the intervention showed that:(1)Compared within the group,RA related clinical indexes of the experimental group after the intervention were better than those before the intervention,and the difference was statistically significant(P < 0.05).After the intervention,RA related clinical indexes of the control group were better,and significant difference was found(P < 0.05).(2)However,the difference of RA related clinical indexes before and after intervention in the experimental group were better,with statistical difference(P < 0.05).(6)The results of DAS score comparison between the two groups indicated that:(1)After the intervention the DAS28 score of the experimental group was better with statistical difference(P < 0.05);The DAS28 score of the control group was also better with statistical difference(P < 0.05).(2)The difference of DAS28 score in the experimental group was greater than that in the control group,with statistical difference(P < 0.05).Conclusions:1.The oral self-health management training program constructed in this study is feasible and scientific.2.The oral self-health management training program constructed in this study can improve the self-care ability,oral health-related quality of life,periodontal index,RA related clinical indicators and DAS 28 score of patients with rheumatoid arthritis and periodontitis,which can slow down the progress of the disease and can be popularized in patients.