Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Self-Management Intervention for Reducing Depression and Anxiety in Osteoarthritis Patients : A Meta-analysis

골관절염 환자의 우울과 불안 감소를 위한 자가관리중재의 효과: 메타분석

  • Received : 2019.10.21
  • Accepted : 2020.02.07
  • Published : 2020.02.29
Download PDF
⟨ Previous Next ⟩

Abstract

This study conducted a meta-analysis of the effects of self-management intervention for reducing the depression and anxiety of osteoarthritis patients. The research sources were PubMed, EMBASE, CINAHL, Ovid-MEDLINE and Korean databases from the Korean and foreign literature published until September 30, 2019. The R version 3.5.1 program was used to identify the effectiveness of self-management intervention. As a result, 11 studies from a total of 1,877 articles in the relevant literature were analyzed, and the total number of participants was 2,751. The results showed that the overall effect size for reducing depression and anxiety was -0.44 (95% CI: -0.66, -0.22) in osteoarthritis patients (p <.001). On the sub-analysis, depression was -0.37 (95% CI: -0.66, -0.08), and anxiety was -0.56 (95% CI: -0.92, -0.20). To explain the heterogeneity, the meta-ANOVA was the setting, duration, and provider of intervention. Analysis of the publication bias was performed by a Funnel plot, which was visually relatively symmetrical and was not asymmetric according to Egger's Regression test (bias=0.19, p=.928). The results of this study established clinical evidence by identifying the effects of self-management intervention for reducing the depression and anxiety of osteoarthritis patients.

본 연구는 골관절염 환자의 우울과 불안 감소를 위한 자가관리중재의 효과를 메타분석한 연구로 자가관리중재의 객관적인 근거를 제시하기 위해 수행되었다. 연구방법으로는 PubMed, EMBASE, CINAHL, Ovid-MEDLINE과 Korean database에서 2019년 9월 30일까지 발표된 국내·외 문헌을 검색하였고, 자가관리중재의 효과 크기를 분석하기 위해 R version 3.5.1 프로그램을 이용하였다. 연구결과로는 총 1,877편의 문헌 중 11편의 연구가 최종 분석되었고, 참가자는 총 2,751명이었다. 자가관리중재 분석결과 골관절염 환자의 우울과 불안 감소를 위한 전체 효과크기는 -0.44(95% CI: -0.66, -0.22)로 작은 정도의 유효한 차이를 보였다(p<.001). 하위분석으로 우울은 -0.37(95% CI: -0.66, -0.08)로 작은 효과크기, 불안은 -0.56(95% CI: -0.92, -0.20)으로 중간정도의 효과크기를 나타냈다. 이질성을 설명하기 위해 중재 장소, 중재 기간, 중재 제공자에 대한 meta-ANOVA를 실시하였다. 출판오류 분석은 funnel plot으로 분석하였고, 시각적으로 비교적 대칭이었으며, egger's regression test로 비대칭이 아님을 확인하였다(bias=0.19, p=.928). 본 연구의 결과는 골관절염 환자의 우울과 불안 감소를 위한 자가관리중재의 효과를 확인하여 임상적 근거를 마련하였다.

Keywords

References

  1. Centers for Disease Control (CDC). (2019). Osteoarthritis [Internet]. CDC, 2019 [cited 2019 Jan]. Available from: https://www.cdc.gov
  2. A. Sharma, P. Kudesia, Q. Shi, R. Gandhi, "Anxiety and depression in patients with osteoarthritis: impact and management challenges", Open Access Rheumatology, Vol.8, pp.103-113, 2016. DOI: https://doi.org/10.2147/oarrr.s93516
  3. D. Guglielmo, J. M. Hootman, M. A. Boring, L. B. Murphy, K. A. Theis, "Symptoms of anxiety and depression among adults with arthritis-United States, 2015-2017", Morbidity and Mortality Weekly Report, Vol.67, No.39, pp.1081-1087, 2018. DOI: https://doi.org/10.15585/mmwr.mm6739a2
  4. F. P. Kroon, L. R. van der Burg, R. Buchbinder, R. H. Osborne, R. V. Johnston, "Self-management education programmes for osteoarthritis", Cochrane Database of Systematic Reviews, Vol.1, No.CD00896 3, pp.1-238, 2014. DOI: https://doi.org/10.1002/14651858.cd008963.pub2
  5. N. Walsh, V. Salmon, J. Pearson, "A systematic identification and assessment of self-management apps for osteoarthritis", Osteoarthritis & Cartilage, Vol.24, pp.S491-S491j, 2016. DOI: https://doi.org/10.1016/j.joca.2016.01.900
  6. C. Y. Lee, Y. H. Cho, "Evaluation of a community health practitioner self-care program for rural Korean patients with osteoarthritis", Journal of Korean Academy of Nurssing, Vol.42, No.7, pp.965-973, 2012. DOI: https://doi.org/10.4040/jkan.2012.42.7.965
  7. G. Foster, S. J. Taylor, S. E. Eldridge, J. Ramsay, C. J. Griffiths, "Self-management education program- mes by lay leaders for people with chronic conditions", Cochrane Database of Systematic Reviews, No.Cd005108, 2007. DOI: https://doi.org/10.1002/14651858.cd005108.pub2
  8. S. O. Nolte, R. H. Osborne, "A systematic review of outcomes of chronic disease self-management interventions", Quality of Life Research, Vol.22, No.7, pp.1805-1816, 2013. DOI: https://doi.org/10.1007/s11136-012-0302-8
  9. S. Y. Kim, J. E. Park, Y. J. Seo, B. H. Jang, H. J. Son, H. S. Suh. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. p.65-78, National Evidence-based Healthcare Collaborating Agency, 2011.
  10. J. Cohen. Statistical power analysis for the behavioral sciences, 2nd ed. Hillsdale, Lawrence Erlbaum Associates, 1998.
  11. J. H. Barlow, A. P. Turner, C. C. Wright, "A randomized controlled study of the arthritis self- management programme in the UK", Health Education Research, Vol.15, No.6, pp.665-680, 2000. DOI: https://doi.org/10.1093/her/15.6.665
  12. K. L. Bennell, R. K. Nelligan, C. Rini, F. J. Keefe, J. Kasza, "Effects of internet-based pain coping skills training before home exercise for individuals with hip osteoarthritis (HOPE trial): a randomised controlled trial", Pain, Vol.159, No.9, pp.1833-1842, 2018. DOI: https://doi.org/10.1097/j.pain.0000000000001281
  13. C. E. Blixen, K. A. Bramstedt, J. P. Hammel, B. C. Tilley, "A pilot study of health education via a nurse-run telephone self-management programme for elderly people with osteoarthritis", Journal of Telemedicine and Telecare, Vol.10, No.1, pp.44-49, 2004. DOI: https://doi.org/10.1258/135763304322764194
  14. D. Bossen, C. Veenhof, K. E. Van Beek, P. M. Spreeuwenberg, J. Dekker, "Effectiveness of a webbased physical activity intervention in patients with knee and/or hip osteoarthritis: randomized controlled trial", Journal of Medical Internet Research, Vol.15, No.11, pp.e257, 2013. DOI: https://doi.org/10.2196/jmir.2662
  15. M. Crotty, J. Prendergast, M. W. Battersby, D. Rowett, S. E. Graves, "Self-management and peer support among people with arthritis on a hospital joint replacement waiting list: a randomised controlled trial", Osteoarthritis Cartilage, Vol.17, No.11, pp.1428-1433, 2009. DOI: https://doi.org/10.1016/j.joca.2009.05.010
  16. M. V. Hurley, N. E. Walsh, H. Mitchell, J. Nicholas, A. Patel, "Long-term outcomes and costs of an integrated rehabilitation program for chronic knee pain: a pragmatic, cluster randomized, controlled trial", Arthritis Care Research, Vol.64, No.2, pp. 238-247, 2012. DOI: https://doi.org/10.1002/acr.20642
  17. M. V. Hurley, N. E. Walsh, H. L. Mitchell, T. J. Pimm, E. Williamson, "Economic evaluation of a re- habilitation program integrating exercise, self-manage- ment, and active coping strategies for chronic knee pain", Arthritis Care Research, Vol.57, No.7, pp.1220 -1229, 2007. DOI: https://doi.org/10.1002/art.23011
  18. S. A. Jessep, N. E. Walsh, J. Ratcliffe, M. V. Hurley, "Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain", Physiotherapy, Vol.95, No.2, pp.94-102, 2009. DOI: https://doi.org/10.1016/j.physio.2009.01.005
  19. Y. I. Kim, J. S. Park, "Development and evaluation of a joint health self-management program for the elderly with knee osteoarthritis in communities: applying the IMB model", Journal of Korean Academy of Community Health Nursing, Vol.28, No.1, pp.55-68, 2017. DOI: https://doi.org/10.12799/jkachn.2017.28.1.55
  20. N. Y. Lim, E. Y. Lee, "Effects of short term selp-help education of pain, depression, self-efficacy, and quality of life in patients having chronic arthritis", Journal of Muscle and Joint Health, Vol.4, No.2, pp.249-261, 1997.
  21. K. Lorig, M. Seleznick, D. Lubeck, E. Ung, R. L. Chastain, "The beneficial outcomes of the arthritis self-management course are not adequately explained by behavior change", Arthritis Rheumatism, Vol.32, No.1, pp.91-95, 1989. DOI: https://doi.org/10.1002/anr.1780320116
  22. E. G. Mann, S. LeFort, E. G. Van Den Kerkhof, "Self-management interventions for chronic pain", Pain Management, Vol.3, No.3, pp.211-222, 2013. DOI: https://doi.org/10.2217/pmt.13.9
  23. S. Du, L. Hu, J. Dong, G. Xu, X. Chen, "Self-management program for chronic low back pain: a systematic review and meta-analysis", Patient Education Counseling, Vol.100, No.1, pp.37-49, 2017. DOI: https://doi.org/10.1016/j.pec.2016.07.029
  24. N. H. Jonkman, H. Westland, R. H. Groenwold, S. Agren, M. Anguita, "What are effective program characteristics of self-management interventions in patients with heart failure? an individual patient data meta-analysis", Journal of Cardiac Failure, Vol.22, No.11, pp.861-871, 2016. DOI: https://doi.org/10.1016/j.cardfail.2016.06.422
  25. K. L. Whiteman, M. C. Lohman, S. J. Bartels, "A peer and technology-supported self-management intervention", Psychiatric Services, Vol.68, No.4, pp.420, 2017. DOI: https://doi.org/10.1176/appi.ps.68404