Effect Of Video Education Combined With Teach-back On Home-based Exercise Compliance And Rehabilitation In Patients With Rheumatoid Arthritis

ObjectivesTo investigate the effects of video education combined with Teachback on home-based exercise compliance and rehabilitation in patients with rheumatoid arthritis(RA);To explore a continuing care model suitable for current hospital-to-family exercise;As well as to provide an implementing scheme and scientific basis for developing and enriching the health education models for exercise in RA patients.MethodsBy using the randomized controlled trail,from March to November 2018,80 RA patients who were admitted to the department of rheumatology and immunology of a top three general hospital in Sichuan Province were recruited and randomly divided into the intervention group and control group(40 cases each).3 days before discharge,patients in the control group received regular discharge guidance,and the primary nurse orally educated the importance,principles and precautions of exercise and demonstrated it one by one.Patients in the intervention group implemented video education combined with Teach-back on the basis of the control group and downloaded exercise video;After discharge,the frequency of home-based exercise was:5 days per week,2 times a day,20 minutes each time;Time period was:morning and bedtime;The duration was:3 days before discharge to 3 months after discharge,and the method and frequency of follow-up were the same.Before intervention,1 month and 3 months after the intervention,the home-based exercise compliance scale,morning stiffness time,pain score,fatigue score,disease activity score(Disease Activity Score in 28 Joints,DAS28)were measured as to evaluate homebased exercise compliance,disease-related symptoms and disease activity of patients in each group;Before the intervention and 3 months after the intervention,the two groups' quality of life were evaluated by using the Health Assessment Questionnaire Disability Index(HAQ-DI).ResultsA total of 73 subjects were included(37 for the control group and 36 for the intervention group).The results showed: 1.1 month and 3 months after the intervention,the home-based exercise compliance of the intervention group was better than that before the intervention(P<0.017)and the control group(P<0.05).2.1 month after the intervention,the morning stiffness time and pain score of the intervention group were lower than those before the intervention(P<0.05),and the fatigue score was lower than that before the intervention and the control group(P<0.05);3 months after the intervention,the morning stiffness time,fatigue score and pain score of the intervention group were lower than those before the intervention and the control group(P<0.05).The longer the intervention time,the better the effect.3.1 month after the intervention,Patient General Health(GH),DAS28 were lower than those before intervention(P<0.05),and the Tender Joint Count(TJC28),Swollen Joint Count(SJC28)were lower than those before the intervention and the control group(P<0.05);3 months after the intervention,the Erythrocyte Sedimentation Rate(ESR)and DAS28 in the intervention group were lower than those before the intervention(P<0.05).TJC28,SJC28,and GH were lower than those before the intervention and the control group(P<0.05).The longer the intervention time,the better the effect,but the effects of ESR and DAS28 score were not significant(P>0.05).4.3 months after the intervention,the HAQ-DI scores of the intervention group were lower than that before the intervention and the control group(P<0.05).Among them,the differences in dressing and washing,eating,personal hygiene,fetching,grasping,and daily life dimensions were statistically significant(P<0.05),there was no significant difference in the two dimensions of standing and walking(P>0.05).ConclusionsVideo education combined with Teach-back can improve the homebased exercise compliance of RA patients,and also help to relieve the symptoms of morning stiffness,fatigue and pain and reduce Tender Joint Count(TJC28),Swollen Joint Count(SJC28),and lower Patients General Health(GH).The longer the intervention time,the better the effect.Thus to improve the quality of life and promote the rehabilitation status of RA patients.