Nursing Education & Research

Biography

Amir Hossein Hossein Pour is an Undergraduate Nursing Student. He works as a Researcher at the School of Nursing and Midwifery of Lorestan University of Medical Sciences (Iran). He has research experience in cardiac and chronic care.

 

 

Abstract

Statement of the Problem: There is evidence that participation in self-management programs is beneficial for patients with musculoskeletal disorders and a large number of trials have been performed; however, the conclusions are not consistent with each other. The purpose of this review study was to evaluate the impact of self-management interventions in improving health outcomes/statues for patients with musculoskeletal disorders.

Methodology & Theoretical Orientation: In this review study PubMed, CINAHL, and EMBASE were searched for intervention studies published between 2000 and 2015 with the following Mesh terms: pain, disability, fatigue, quality of life, depression, distress, health outcome, health statues, rheumatoid arthritis, fibromyalgia, arthritis, neck/back pain and self-management or self-care. We included randomized controlled trials (RCTs) of self-management interventions that enrolled patients 18 years of age or older who were diagnosed with musculoskeletal disorders. Articles were limited to journals published in English-language. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool.

Findings: In this review, 21 studies which met the review criteria were fully retrieved and appraised. Fourteen of 21 studies with 6581 patients measured health outcomes. Outcomes were grouped into clinical improvement, and improved health status. Six out of 10 studies that measured pain intensity, disability and fatigue reported significant reduction among those receiving self-management programs. In 5 RCTs, there were significant improvement in health distress, depression, activity limitation, global health, and self-efficacy with long term benefits for depression and quality of life subscales (to 12 months follow up). The findings of two study showed that self-management programs have small to moderate effects in improving pain and disability at the long-term level (16-18 weeks), but the medium-term (8 weeks) effect for disability is not significant. Finally in one study, no significant reduction in pain was recorded.

Conclusion & Significance: Our findings suggest that self-management programs had a positive effect in reducing pain, fatigue and in improving health outcomes/ statues.