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- Status: Published
Purpose:
The purpose was to implement a self-management program to decrease pain and disability and improve self-efficacy among low-income, Latino individuals diagnosed with arthritis.
Background:
All arthritis pain has the potential to impair mobility. Arthritis is the leading cause of disability among American adults, with over 50 million individuals affected. The Latino population experiences a disproportionate incidence of disability attributable to arthritis compared to other populations. Evidence supports self-management education incorporating physical activity as a promising intervention for arthritis.
Methods:
The intervention included a curriculum developed by the Arthritis Association, three teaching sessions, and a pre/post-test. Anticipated outcomes included decreased pain measured by the Pain Visual Numeric, decreased report of disability measured by the Stanford HAQ, and increased self-efficacy measured by the Arthritis Self-Efficacy Scale. The setting was a faith-based medical clinic that services the uninsured population located within Southwest Arizona. Participants included Spanish and English speaking adults diagnosed with arthritis.
Results:
Twelve participants were consented however, only eight participants completed the entire project. Although the mean pain score decreased, indicating reduced pain, it was not statistically significant (pretest- M=5.75 SD=3.19; posttest- M=5.25 SD=2.82; z (7)=-.11, p= .92). However, there was a statistically significant increase in reports of exercise after the intervention (pretest M=.83, SD=.39; posttest- M=.43, SD=.53; z (6)=-2.0, p =.046). This was in response to an non validated question developed by the primary investigator and co-investigator of, “Do you currently exercise?”.
Conclusions:
Results include increases in reports of exercise post-intervention and decreased pain. The use of non-pharmacological interventions such as self-management to reduce pain and increase mobility in arthritic patients can help lessen the socioeconomic health disparity gaps.
Purpose/Aims: The purpose of this project was to increase the rate of depression screening for patients with chronic musculoskeletal disorders in the physical therapy setting.
Methods: The institutional review board at Arizona State University approved this study with exempt status.
Depression screening with a Patient Health Questionnaire (PHQ-9) was completed by adult clients in three outpatient physical therapy clinics in the Midwest and Southwest United States (n=165). Degree of depression and patient response rates were measured and analyzed using descriptive statistics.
Staff were surveyed prior to and post project completion regarding their viewpoints on IPC and depression in this patient population. Staff demographics were analyzed and they were evaluated on their change in perception of the problem and their likelihood of sustainability with a Wilcoxin Signed Ranks Test.
Outcomes: Patient response rate was 91.5% (n=165) exposing a mean PHQ-9 score of 5.01 (mild depression). More notably, patients whom had an existing diagnosis of depression had a mean PHQ-9 score 10.47 (moderate depression) indicating poorly controlled symptoms.
After an educational session to increase knowledge, staff perception of the problem did not significantly change, with a mean score of 2.25 out of 5 predicting “somewhat” likelihood of project sustainability.
Conclusion: Implementing a PHQ-2 rather than PHQ-9 depression screening into patient’s electronic medical records would resolve staff and patient concerns of time consumption while simultaneously improving the rates of depression screening and management in patients with chronic musculoskeletal disorders.