The Application Of Exercise Intervention Based On Hope Theory With Rheumatoid Arthritis

To learn more about the barriers of functional exercise in rheumatoid arthritis patients.To evaluate the effect of the program on hope level,exercise self-efficacy,upper limb function,pain,ESR in patients with rheumatoid arthritis.Methods:Part ?,Qualitative research.The purpose sampling method was used to select 12 rheumatoid arthritis patients who visited the Bethune Hospital of Shanxi Province from May to August 2019 as the research object.The phenomenological method was used to conduct semi-structured in-depth interviews to understand the hindering factors of functional exercise in patients with rheumatoid arthritis.Part ?,Experimental research.The second part adopts the convenience sampling method.35 patients with rheumatoid arthritis who were treated in the Rheumatology and Immunology Department of Shanxi Bethune Hospital from November 2018 to January2019 were selected as the control group.35 patients with rheumatoid arthritis who were treated from February to April 2019 were selected.Patients with arthritis were the intervention group.The control group was guided by routine upper limb functional exercise;the intervention group was based on the control group to implement interventions for upper limb functional exercise based on the theory of hope.The general questionnaire,Herth Hope Scale,Upper Limb Function Evaluation Scale,and Exercise Self-Efficacy Scale were used for intervention Postoperative patients were assessed for exercise self-efficacy,hope level,upper extremity function,pain,and ESR.Changes of Herth Hope Level Score,Upper Limb Function Scale Score,Exercise Self-Efficacy Score,Pain Level,and ESR were compared between the two groups before and after 3 months of intervention.The data before and after the intervention group and the control group were compared and analyzed by t-test statistics.Result:1.Qualitative research: A total of 12 patients were thoroughly interviewed.After repeated reading,analysis,classification and extraction of the interview data,four topics were summarized: cognitive factors,factors related to disease symptoms,emotionalfactors,lack of social support system.2.Comparison of the hope level scores between the two groups of patients before and after the intervention: There was no significant difference in the total hope level scores and three dimensions of the two groups of patients before the intervention(P >0.05).The scores and scores of positive actions were higher than those before intervention and the control group,and the differences were statistically significant(P <0.05).The score of the intimate relationship between the control group and others was higher than the control group but the difference was not statistically significant(P> 0.05).3.Comparison of upper limb function scores between the two groups of patients before and after the intervention: there was no significant difference in upper limb function scores between the two groups of patients before the intervention(P> 0.05).After intervention,the upper limb function scores of the patients in the intervention group were lower than those in the control group,and the differences were statistically significant.(P<0.05).4.Comparison of exercise self-efficacy scores between the two groups of patients:There was no significant difference in exercise self-efficacy scores between the two groups of patients before the intervention(P> 0.05).The study group's exercise self-efficacy score was significantly higher than that of the control group after implementing the desired nursing intervention.The difference was statistically significant(P <0.05).5.Comparison of visual analogue pain scoreand ESR between the two groups:There was no significant difference in visual analogue pain score,morning stiffness time and ESR between the two groups before intervention(P>0.05).After the intervention,the visual analogue pain score was lower than those of the control group(P<0.05),there was no significant difference in ESR between the two groups(P>0.05).Conclusion:1.Obstructive factors for patients with rheumatoid arthritis not performing functional exercise include cognitive factors,factors related to disease symptoms,emotional factors and lack of social support system.Health workers should provide patients with a clear exercise program,strengthen the full cycle guidance before and afterdischarge,in order to improve patients' cognitive level and exercise ability;Timely evaluate patients' disease symptoms,adjust exercise intensity,to help patients to overcome their fear of movement;Actively guide patients' negative emotions,and pay more attention to the construction of patients' social support system,which could improve patients' exercise compliance.2.The exercise intervention based on hope theory can improve the hope level of patients with rheumatoid arthritis,improve the self-efficacy of patients with functional exercise,improve the upper limb function of patients,and reduce the feeling of joint pain.