1. Rhematoid Rthritis Respiratory disorders
Mohammed Zaky

2. Rhematoid Rthritis
IMPACT OF SELF-MANAGEMENT TECHNIQUES ON SELF-EFFICACY AMONG PATIENTS WITH RHEUMATOID ARTHRITIS AT A UNIVERSITY HOSPITAL IN CAIRO
Mohammed Zaky
Mohammed Zaky

3. Rhematoid Rthritis
Introduction
Rheumatoid arthritis (RA) is a chronic inflammatory disorder that is most likely to be debilitating. It is associated with increased mortality in contrast with the overall population because of the outcomes of the disease and treatments strategies, (Dougados et al., 2014 and Ranade & Gaud, 2013).
Mohammed Zaky

4. Rhematoid Rthritis
Cont’
Its incidence is about 1-2% of the overall populace and affects females three times more than males (Menon, 2012).
Mohammed Zaky

5. Rhematoid Rthritis
Cont’
There are 2 main variables in this study (1) Self-efficacy which is defined as the belief in one’s capabilities to organize and execute the course of action required to manage prospective situation, self-efficacy gives one a sense of control over the environment.
Mohammed Zaky

6. Rhematoid Rthritis
(2) Self Management Techniques refers to behavioral interventions and healthful tasks that are performed by the patient to overcome or adapt with symptoms of chronic illness. The goal is to increase skills, confidence, decrease pain, fatigue, disability, anxiety and depression.
Mohammed Zaky

7. Aim of The Study
The aim of this study is to evaluate the impact of self-management techniques on self-efficacy among patients with rheumatoid arthritis at a university hospital in Cairo.
Mohammed Zaky

8. Significance of the study
Rhematoid Rthritis
Significance of the study
According to World Health Organization (2013), the prevalence of RA varies between 0.3% and 1% and is more common among women and in developed countries.
Mohammed Zaky

9. Cont’.
The last annual statistics of newly diagnosed RA among Egyptian patients attending the Rheumatology Clinic at Cairo University Hospital during 2013 accounted for 59.3% of all admissions in that department (Statistics and Medical Records Department, 2013).
Mohammed Zaky

10. Materials & Methods Research hypothesis
The patients who will receive self-management techniques will show higher levels of self-efficacy.
Mohammed Zaky

11. Pre-Assessment Intervention Post-Assessment
Research Design
One-group Pre-Test / Post-Test research design was used to evaluate causal relationships between intervention and outcome.
Pre-Assessment Intervention Post-Assessment
O X O2
Mohammed Zaky

12. Sample Confirmed diagnosis with RA
Rhematoid Rthritis
Sample
A random sample of 30 adult patients were chosen for the current study, the following criteria were established for sample inclusion :
Confirmed diagnosis with RA
Age range between 30 and 50 years that are fully conscious
a written prescription treatment plan and with no recommendation for surgical management
can communicate verbally, with no visual and cognitive impairment
Mohammed Zaky

13. Procedure
All the study subjects were assessed by arthritis self efficacy scale 3 times, also they performed demonstration and re-demonstrated of all exercises provided in self-management techniques booklet. Moreover through the time of implementation and evaluation phase there were follow up to patients by either meeting or by telephone calls.
Mohammed Zaky

14. Tools of Data Collection
Rhematoid Rthritis
Tools of Data Collection
Structured Interview Questionnaire
Socio-demographic data.
Medical back ground sheet.
Arthritis-Self Efficacy
1-Pain scale
2-Function scale
3-Other symptoms scale
It consists of two parts; the first part covers data related to Socio-demographic characteristics such as age, education, work place, marital status, exercise, smoking and income
The second part covers medical background data such as comorbidities, signs and symptoms of rheumatoid arthritis, medications, vital signs, height and weight
Arthritis self efficacy Which covers 1- Pain scale 2- function scale 3- other symptoms scale
Mohammed Zaky

15. Regarding to socio-demographic data
Rhematoid Rthritis
Results Of The Study
Regarding to socio-demographic data
Regarding to socio-demographic data
The age of study subjects ranged from 30 years to 50 years with a mean of 39.7± 6.5 years
and the range of considered as 56.6% of the study subjects and the range from years was considered as 43.3% of the study subjects
Mohammed Zaky

16. Gender Rhematoid Rthritis
Female patients consists the majority of study subjects by 80% of them while the male was 20% of the study subjects
Mohammed Zaky

17. Level of education Rhematoid Rthritis
Level of education varies between study subjects as follows: read and write was 53.3% of study subjects, primary school level10% of study subjects, preparatory school level10% of study subjects, secondary school level was 13.3% of study subjects and bachelor degree was 13.3% of study subjects.
Mohammed Zaky

18. Practice of Exercise Rhematoid Rthritis
93.3% of the study subjects were not practicing exercise while 6.7% of study subjects were practicing exercise
Mohammed Zaky

19. Signs and Symptoms Rhematoid Rthritis
According signs and symptoms of RA patients were suffering from Arthralgia, continous ftigue, stiffness, inability to perform ADLs and joint swelling by 97%, 90, 83%, 80% and 76% respectively
Mohammed Zaky

20. Comorbidities Rhematoid Rthritis
According to comorbidities 10% of S. S were DM, 6% were suffering from HCV and 6% were suffering from 6%/ HTN and 78% were free from any comorbidities
Mohammed Zaky

21. Medication Prescribed for RA
Rhematoid Rthritis
Medication Prescribed for RA
According to medication prescribed for RA , 76% of SS were receiving cortisone , 70% were receiving Dmars, 66.6% were receiving Methotrixate and 53.3 were receiving NSAIDs
Mohammed Zaky

22. Self Efficacy Pain Scale Rhematoid Rthritis
In relation to Self efficacy regarding pain scale 1st SE ass. Was 24, 2nd SE ASS. Was 29 and 3rd SE ass. Was 33
Mohammed Zaky

23. Self Efficacy Function Scale
Rhematoid Rthritis
Self Efficacy Function Scale
In relation to Self efficacy regarding function scale 1st SE ass. Was 63.3, 2nd SE ASS. Was 62.9 and 3rd SE ass. Was 65.5
Mohammed Zaky

24. Self efficacy Other Symptoms Scale Rhematoid Rthritis
In relation to Self efficacy regarding other symptoms scale 1st SE ass. Was 38.06, 2nd SE ASS. was and 3rd SE ass. Was 38.4
Mohammed Zaky

25. Total score of arthritis self efficacy
Rhematoid Rthritis
Total score of arthritis self efficacy
According to totale score of arthritis self efficacy scale 1st SE Ass was , 2nd SE Ass was rd SE Ass was
Mohammed Zaky

26. Recommendations
Follow up for all RA patients to assess their health conditions and to detect early complication or medication side effects.
Establish a center for the education of patients with RA provided with teaching aids and facilities to teach patients and their families’ ways to live with RA.
Mohammed Zaky

27. Self-management techniques through patients education should become an integrated part of the total management of rheumatoid arthritis patient.
Long- term effects of following self-management techniques need to be further studied.
Mohammed Zaky

28. Conclusion
The study revealed that the self-management techniques delivered to the patients with RA which included exercises, rest, diet, heat and cold packs and adherence to medications have resulted in improving self-efficacy. This was in terms of pain reduction, improved functional abilities and improving other symptoms of RA among studied patients.
Mohammed Zaky

29. Mohammed Zaky