Sigma's 30th International Nursing Research Congress

The Comprehensive Health Education Program for Overweight and Diabetic Older Adults With Knee Osteoarthritis

Yuwadee Saraboon, MNS Boromrajjachonnee College of Nursing , , Muang Distric, Nakhon Phanom Province, 48000 Tel: 66-4251-2196, Boromrajjachonnee College of Nursing Nakhon Phanom, Nakhon Phanom University, Boromrajjachonnee College of Nursing,, Thailand Suparb Aree-Ue, PhD Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, , Bangkok, Thailand

Purpose: Health education is essential in improving self-care management (Ali, Kokorelias, MacDermid & Kloseck, 2018, Espanha, Marconcin, Campos, & Yázigi, 2017, Hunter et.al, 2018, Ganji, Pakniat, Armat Tabatabaeichehr, Mortazavi, 2018).yet less investigated in older adults with knee osteoarthritis who have type 2 diabetics and overweight or obesity. Evidence revealed that modification self-care behaviour focusing on knowledge, self-efficacy and outcome expectations is the key for reducing severity of OA progression especially in older adults with type 2 diabetes and overweight or obesity.(Marks, 2014, Mark, 2017, Marszalek, Price, Harvey, Driban, & Chenchen, 2017, Mielenz et. al., 2013, Mihalko, 2018).To enhance the quality of care; thus, this study aimed to explore the effects of a comprehensive health education program on knowledge of knee osteoarthritis, self-efficacy, and expectation of treatment outcomes of this population.

Methods: This quasi-experimental research was conducted in 119 overweight and diabetic older adults with knee osteoarthritis based on the diagnostic criteria of American College of Rheumatology. The participants joined the comprehensive health education program, including 1) providing health knowledge / information, 2) doing physical activities and 3) providing knowledge about food / nutrition. Data were collected before and after 2 weeks of the experiment by using knee osteoarthritis knowledge test, a questionnaire on self-efficacy and a questionnaire on expectation of treatment outcomes. Data were analyzed using Paired t-test.

Results: The results showed that after the experiment, the scores of the participants were: knowledge of knee osteoarthritis (Mean ± SD = 7.66 ± 1.17), self-efficacy (Mean ± SD = 26.07 ± 2.84) and expectation of treatment outcomes (Mean ± SD = 10.68 ± 4.33). They were significantly higher than those of before the experiment: knowledge about knee osteoarthritis (Mean ± SD = 6.68 ± 1.12), self-efficacy (Mean ± SD = 22.68 ± 4.33) and expectation of treatment outcomes (Mean ± SD = 8.98 ± 2.36) with statistical significance (P <.001, P <.001, P <.001, respectively).

Conclusion: Health professionals should use this program as a guideline to prevent and control knee osteoarthritis, especially with overweight and diabetic older adults with knee osteoarthritis. Applying effective health education program has more benefit in providing better care in overweight and diabetic older adults with knee osteoarthritis

Title:

The Comprehensive Health Education Program for Overweight and Diabetic Older Adults With Knee Osteoarthritis

Keywords: expectation of treatment outcomes, knowledge of knee osteoarthritis and self-efficacy

References:

Ali, SA., Kokorelias, KM., MacDermid, JC. & Kloseck, M. (2018). Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review. Hindawi Arthritis. 2018, 1-8. Article ID 2496190.

Espanha, MR., Marconcin, PP., Campos, PL. & Yázigi, FG. (2017). Educational program for older adults with knee osteoarthritis. Annals of the Rheumatic Diseases. 76. 1553-1567 DOI:10.1136/annrheumdis- 2017-eular.6642

Hunter JD., Hinman, RS., Bowden, Lj., Egerton, T., Briggs, MA., Bunker, JS. Kasza,6 Andrew B., et al. (2018). Effectiveness of a new model of primary care management on knee pain and function in patients with knee osteoarthritis: Protocol for THE PARTNER STUDY. BMC Musculoskeletal Disorders. (2018) 19:132.

Ganji, R., Pakniat, A., Armat, MR., Tabatabaeichehr, M. & Mortazavi, H. (2018). The Effect of Self- Management Educational Program on Pain Intensity in Elderly Patients with Knee Osteoarthritis: A Randomized Clinical Trial. Open Access Macedonian Journal of Medical Sciences. 6(6):1062-1066.

Mielenz, TJ., Kubiak-Rizzone, KL, Alvarez, KJ. (2013) Association of self-efficacy and outcome expectations with physical activity in adults with arthritis. Arthritis 2013(2013): 621396 (8 pp.).

Mark, R. (2014). Self-efficacy and arthritis disability: An updated synthesis of the evidence base its relevance to optimal patient care Health Psychology Open. Health Psychology Open. 1–18. DOI: 10.1177/2055102914564582

Mark, R. (2017). Self-Efficacy-an Important Arthritis Pain Correlate and Treatment Factor General Review and Commentary. Novel Techniques in Arthritis & Bone Research 1(5). DOI: 10.19080/NTAB.2017.01.555574

Marszalek, J., Price, LL., Harvey, FW., Driban, B. & Wang, C. (2013). Association of Self-Efficacy and Outcome Expectations with Physical Activity in Adults with Arthritis. Hindawi Arthritis.2013.1-8.

Mihalko, LS., Cox, P., Beavers, PD., Miller, DG., Nicklas JB., Lyles M., et al. (2018). Effect of intensive diet and exercise on self-efficacy in overweight and obese adults with knee osteoarthritis. The IDEA randomized clinical trial. Behavioral Medicine. 2018. 1-9.

Abstract Summary:

To explore the effects of a comprehensive health education program on knowledge of knee osteoarthritis, self-efficacy, and expectation of treatment outcomes in overweight and diabetic older adults with knee osteoarthritis.

Content Outline:

I.Introduction A: Health education is essential in improving self-care management.

B: knowledge, Self-efficacy and outcome expectations is the key for reducing severity of OA progression especially in older adults with type 2 diabetes and overweight or obesity.

II.Body

A. Main Point# 1 a) to explore the effects of a comprehensive health education program on knowledge of knee osteoarthritis, self-efficacy, and expectation of treatment outcomes diabetic older adults with knee osteoarthritis.

B.Main Point # 2

1. design a) The quasi-experimental design. b) The intervention group received the essential knowledge: health information, physical activities, and nutrition.

2. sample a) 119 community-dwelling diabetic older adults with knee osteoarthritis. b) inclusion criteria: age 60 or over; overweight and diabetic older adults with knee osteoarthritis based on the diagnostic criteria of the American College of Rheumatology; no cognitive impairment; and independent in performing activities of daily life.

3. data collection and analysis a) using questionnaires: 1) The OA knowledge test,

, 2) The self-efficacy questionnaire 3) The outcome expectations questionnaire b) analysis using descriptive statistics and Paired t-test.

Main point # 3

1) results a) knowledge of knee osteoarthritis (Mean ± SD = 7.66 ± 1.17) were significantly higher than the baseline (P < .001). b) self-efficacy (Mean ± SD = 26.07 ± 2.84) were significantly higher than the baseline (P < .001).

C) expectation of treatment outcomes (Mean ± SD = 10.68 ± 4.33) were significantly higher than the baseline (P < .001).

III. Conclusion A. Our findings emphasized the effectiveness of the comprehensive health education program on knowledge of knee osteoarthritis, self-efficacy, and expectation of treatment outcomes

First Primary Presenting Author

Primary Presenting Author

Corresponding Primary Presenting Author

Yuwadee Saraboon, MNS Lecturer Boromrajjachonnee College of Nursing, Thailand

Author Summary: Yuwadee Saraboon 2004: Bachelor of Nursing and Midwifery at Police Nursing College 2012: Master Degree of Nursing (Community Health Nursing Practitioner) at School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University. Lecturer, Boromrajjachonnee College of Nursing Nakhon Phanom, Nakhon Phanom University. A lecturer community nursing in Boromrajjachonnee College of Nursing,Nakhon Phanom University, Thailand. -working as a research in the area of Older Adults with Knee Osteoarthritis and publish in international journal.

Second Author

Suparb Aree-Ue, PhD

Mahidol University Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital Associate Professor Ratchatewi Bangkok Thailand

Author Summary: Associate Professor Dr. Suparb Aree-Ue, Department of Adult and Gerontological Nursing, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University. Her research interests are health promotion, nursing; gerontology; orthopaedics; chronic illness.