Rheumatoid Arthritis
Conditions
Keywords
Stress, Coping, Expressive Writing, Self-Efficacy, Disclosure
Brief summary
Self-management of rheumatoid arthritis (RA) symptoms using written emotional disclosure (ED), coping skills training (CST), or a combination of both may benefit people with RA. The purpose of this study is to determine the benefits of ED, CST, or CST and ED together in adults with RA. This study will be conducted at Wayne State University in Detroit, Michigan and Duke University Medical Center in Durham, North Carolina.
Detailed description
Two self-management strategies hold promise for improving the health of people with RA: ED (writing about stress, RA, and coping options) and CST (learning six pain and stress coping skills). A strategy integrating ED with CST may be more effective than either intervention alone. This study will compare the effectiveness of ED, CST, ED in combination with CST, and control groups in alleviating the symptoms of RA. This study will last until May 2009. Participants with RA will be randomly assigned to 1 of 4 treatment groups. Each participant will receive 3 writing sessions and 8 training sessions. Group 1 will receive ED writing followed by CST; Group 2 will receive ED writing followed by arthritis education; Group 3 will receive health behavior writing followed by CST; and Group 4 will receive health behavior writing followed by arthritis education. Participants will be evaluated at baseline and at Months 1, 4, and 12 for pain, physical disability, psychological impairment, and disease activity. In addition, participants will record daily diaries for 30 days regarding their pain, symptoms, coping, stress, and mood prior to each of the evaluations. Changes in health status over time will be compared among groups.
Interventions
BEHAVIORALCoping skills training
8 sessions of pain and stress coping skills training
BEHAVIORALWritten emotional disclosure
4 sessions of writing about stress
BEHAVIORALArthritis education
8 sessions of learning about rheumatoid arthritis
BEHAVIORALHealth behavior writing
4 sessions of writing about various health behaviors
Sponsors
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Wayne State University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Meet American College of Rheumatology (ACR) 1987 criteria for RA
Exclusion criteria
* Other disorders that would significantly affect function (e.g., lupus, chronic obstructive pulmonary disease \[COPD\], congestive heart failure \[CHF\], cancer) * Judged by the physician to have cognitive impairment (dementia, retardation, psychosis) or illiteracy * Has experienced recent (last 6 months) significant stressor resulting in substantial emotional instability * Currently in psychotherapy or a formal behavioral pain management program * Unable to walk. Participants who use walking aids are not excluded. * Physically unable to write
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Joint count | one year |
Secondary
| Measure | Time frame |
|---|---|
| Psychological impairment | one year |
| Pain | one year |
| Physical disability | one year |
| C-reactive protein | one year |
| Fatigue | one year |
Countries
United States
Outcome results
None listed