Enablement and empowerment among patients participating in a supported osteoarthritis self-management programme - a prospective observational study

Karin Sturesdotter Åkesson, Anne Sundén, Kjerstin Stigmar, Cecilia Fagerström, Teresa Pawlikowska, Eva Ekvall Hansson, Karin Sturesdotter Åkesson, Anne Sundén, Kjerstin Stigmar, Cecilia Fagerström, Teresa Pawlikowska, Eva Ekvall Hansson

Abstract

Background: In Sweden, core treatment for osteoarthritis is offered through a Supported Osteoarthritis Self-Management Programme (SOASP), combining education and exercise to provide patients with coping strategies in self-managing the disease. The aim was to study enablement and empowerment among patients with osteoarthritis in the hip and/or knee participating in a SOASP. An additional aim was to study the relation between the Swedish version of the Patient Enablement Instrument (PEI) and the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23).

Methods: Patients with osteoarthritis participating in a SOASP in primary health care were recruited consecutively from 2016 to 2018. The PEI (score range 0-12) was used to measure enablement and the SWE-RES-23 (score range 1-5) to measure empowerment. The instruments were answered before (SWE-RES-23) and after the SOASP (PEI, SWE-RES-23). A patient partner was incorporated in the study. Descriptive statistics, the Wilcoxon's signed rank test, effect size (r), and the Spearman's rho (rs) were used in the analysis.

Results: In total, 143 patients were included in the study, 111 (78%) were women (mean age 66, SD 9.3 years). At baseline the reported median value for the SWE-RES-23 (n = 142) was 3.6 (IQR 3.3-4.0). After the educational part of the SOASP, the reported median value was 6 (IQR 3-6.5) for the PEI (n = 109) and 3.8 (IQR 3.6-4.1) for the SWE-RES-23 (n = 108). At three months follow-up (n = 116), the reported median value was 6 (IQR 4-7) for the PEI and 3.9 (IQR 3.6-4.2) for the SWE-RES-23. The SWE-RES-23 score increased between baseline and three months (p ≤ 0.000). The analysis showed a positive correlation between PEI and SWE-RES-23 after the educational part of the SOASP (rs = 0.493, p < 0.00, n = 108) and at follow-up at three months (rs = 0.507, p < 0.00, n = 116).

Conclusions: Patients reported moderate to high enablement and empowerment and an increase in empowerment after participating in a SOASP, which might indicate that the SOASP is useful to enable and empower patients at least in the short term. Since our results showed that the PEI and the SWE-RES-23 are only partly related both instruments can be of use in evaluating interventions such as the SOASP.

Trial registration: ClinicalTrials.gov. NCT02974036 . First registration 28/11/2016, retrospectively registered.

Keywords: Empowerment; Enablement; Osteoarthritis; Patient education; Patient partner; Physiotherapist; Primary health care.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Flowchart for the collection of participants for analysis in the study
Fig. 2
Fig. 2
Scatterplot showing the correlation between the PEI and the SWE-RES-23 after the educational part of the SOASP (Spearman’s rho (rs) = 0.493; n = 108)
Fig. 3
Fig. 3
Scatterplot showing the correlation between the PEI and the SWE-RES-23 at follow-up at three months (Spearman’s rho (rs) = 0.507; n = 116)

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