Intervention Of Acceptance And Commitment Therapy On Self-efficacy In Patients With Rheumatoid Arthritis

Objective:The purpose of this study is to analyze the research hotspots,trends and trends of acceptance and commitment therapy in China.To investigate the pain,pain belief,emotional status,self-efficacy,psychological elasticity,quality of life,social support status of patients with rheumatoid arthritis,and to explore the influencing factors of self-efficacy.To explore the effect of acceptance and commitment therapy in self-efficacy of rheumatoid arthritis patients.Methods:From 2006 to June 2020,the journal literature on admission and commitment therapy included in the CNKI database was selected for keyword co-word analysis,social network analysis and cluster analysis.From December 2019 to December 2020,210 inpatients were diagnosed as RA in the Department of Rheumatology Immunology,questionnaires were conducted using self-compiled population learning volume,pain visual analogue scale(VAS),pain belief and perception scale(PBPI),depression-anxiety-stress self-rating scale(DASS-21),arthritis self-efficacy scale-8 entry version(ASES-8),resilience scale(CD-RISC),quality of life scale(SF-36)and social support rating scale(SSRS);Descriptive statistical analysis,t test,anova,correlation analysis and regression analysis were performed on the data.The 120 RA patients who met the standard were divided into experimental group and control group by pairing method.The two groups received routine treatment at the same time.In addition,the experimental group carried out structured intervention of acceptance and commitment therapy;psychological evaluation of the two groups before and after intervention;descriptive statistical analysis,chi-square test and t test.Results:Visual analysis shows that:The domestic research on acceptance and commitment therapy mainly focuses on the following four points: the study of ACT and emotional state,the study of ACT and students’ mental health,the study of ACT mechanism,the study of ACT and physical and mental health.The findings of the survey show that:(1)RA self-efficacy level is low.(2)RA patients had differences in sex,age,current marital status,occupation,per capita monthly income,diagnosis time,morning stiffness time,pain intensity,and self-efficacy scores of disease characteristics(P <0.05 or P <0.01).(3)According to the results of regression analysis,the main factors affecting RA patients’ self-efficacy were pain belief,quality of life,psychological elasticity,occupation and pain score.(4)A negative correlation was found between the total score of pain belief and 4dimensions(P <0.01),A positive correlation was found between the total score of mental elasticity and the score of 3 dimensions and the total score of quality of life(P <0.01).Feeling pain is mysterious,thinking that it will continue pain,that pain can not be relieved,self-blame,PBPI total score and self-efficacy score negative correlation,The difference was statistically significant,correlation coefficients between them r values of-0.222 、-0.434、-0.448、-0.264、-0.466,And the P values are less than 0.01;Fortitude,strength,optimism,CD-RISC score were positively correlated with self-efficacy score,The difference was statistically significant,correlation coefficients between them r values of0.374、0.463、0.423、0.437,And P <0.01;PF、RP、BP、GH、VT、SF、RE、MH、SF-36 score was positively correlated with self-efficacy score,The difference was statistically significant,correlation coefficients between them r values of 0.407、0.414、0.600、0.407、0.141、0.438、0.327、0.226、0.530,And the P values are less than 0.05.The results of the intervention study show that:(1)Before intervention,there was no statistical difference in VAS scores,ASES-8scores,PBPI scores,CD-RISC scores,CD-RISC scores,SF-36 total scores and other dimensions(P> 0.05);(2)Inter-group comparison: before intervention,there is no statistical difference between VAS score,ASES-8 score,PBPI score,CD-RISC score,SF-36 total score and other dimensions(P> 0.05);(3)After intervention,the difference between VAS score,ASES-8 score,PBPI score,CD-RISC score and other dimensions has statistical significance(P< 0.05);after intervention,the difference in total SF-36 score and other dimensions except MH dimension(P> 0.05);(4)Comparison in the group: before and after intervention,except for the pain irreversible dimension and self-blame dimension,the VAS score,ASES-8 score,PBPI score,CD-RISC score and SF-36 score themselves,and the difference has statistical significance(P< 0.05);(5)Before and after the intervention,except for the dimension of self-blame feeling,the VAS score,ASES-8 score,PBPI score,CD-RISC score and SF-36 score themselves were compared,and the difference had statistical significance(P< 0.05).Conclusion:(1)The focus of domestic ACT research is as follows: ACT and emotional state research,ACT and students’ mental health research,ACT mechanism research,ACT and physical and mental health research.(2)RA the patient’s sense of self-efficacy is in the medium level,the influencing factors include: occupation,pain intensity,pain belief,psychological elasticity,quality of life.(3)RA patients have negative correlation between pain belief and quality of life,positive correlation between psychological elasticity and quality of life;negative correlation between pain belief and self-efficacy,positive correlation between psychological elasticity and self-efficacy,and positive correlation between quality of life and self-efficacy.(4)ACT-based structured interventions can reduce pain intensity,improve pain beliefs,improve self-efficacy and resilience,and improve quality of life.