The main aim of this study was to explore factors associated with empowerment in patients that have participated in a SOASP. A secondary aim was to evaluate empowerment after SOASP in the longer term.
This explorative analysis including patients from a cohort study was conducted in primary healthcare in Sweden between 2016 to 2018. Univariable linear regression models were performed to assess associations between demographics and patient-reported outcome measures (explanatory factors), respectively, and change in empowerment from baseline to 3-month follow-up (outcome variable). Demographics were age, gender, Body Mass Index, most affected joint, level of education, civil status, and work situation. Patient-reported outcome measures were SWE-RES-23 (measuring empowerment), NRS-11 (measuring pain), questions about physical exercise and everyday exercise, EQ-5D (measuring health-related quality of life) and the Patient Enablement Instrument (measuring enablement). Long-term follow-up of empowerment was at 9 months. To enhance the patient perspective, a patient partner was involved in the study.
In total, 143 patients (mean age 66, SD 9.3 years) were included in the study, 111 (78 %) were women. Self-reported increase in enablement at the 3-month follow-up was associated with a greater improvement in empowerment (B= 0.041, 95% CI (0.011, 0.07), p=0.008). Living alone was associated with less improvement in empowerment (B= -0.278, 95% CI (-0.469, -0.086), p=0.005) compared to living together. Physical exercise >120 minutes per week at baseline was associated with less improvement in empowerment (B=-0.293, 95% CI (-0.583, -0.004), p=0.047) compared to reporting no exercise at baseline. No other associations were observed (p>0.05). Empowerment improved from baseline to the 3-month follow-up (mean 0.20 (SD 0.5), p0.001) but there was no change from baseline to the 9-month follow-up (mean 0.02 (SD 0.6), p=0.641).
Self-reported increased enablement may lead to greater improvement in empowerment after SOASP. However, patients with higher amount of physical exercise at baseline may have less room for improvement in empowerment. Also, greater efforts may be needed to support those that live alone, and to sustain empowerment in the longer term after SOASP. Associations between empowerment and other factors need to be studied further to promote self-management and provide personalized support for patients with OA after SOASP.
The results suggest the need for personalized care. Tailored support, both to enhance enablement and to address the specific needs of individuals with higher amount of physical activity and those living alone, might be important for sustaining empowerment and self-management in the long term after SOASP.
empowerment
self-management program
