Bode and coworkers sought to identify the reasons for limited results of group self-management for rheumatoid arthritis patients and their partners. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were analyzed with respect to motivation to participate and the effects of the program on them. The limited effects of the self-management program appear to be linked with low motivation to participate and to change health behavior. The data showed that a decline in health and an increase in stressful life events might be associated with the disappointing effects of the program. Three strategies were proposed for improving the program's effects: (a) provide information about the program in advance to ensure that patients have appropriate expectations; (b) enhance intrinsic motivation to change health behavior by counseling techniques; and (c) tailoring with respect to motivation and current concerns.

WHAT THIS MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors suggested that preparation before self-management training might improve patients’ motivation for a self-management. Providing information about the program would certainly seem a prudent suggestion. Increasing patients’ motivation regarding the training and tailoring materials for them would likely occur as the patients’ participated in the program and saw the positive results that occurred.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: You need to be motivated if you are going to learn self-management skills to help control your arthritis. The results of the self-management programs for arthritis by Kate Lorig and her colleagues, however, suggest that the payoff of learning and performing self-management skills to control arthritis is well worth the effort.

C Bode et al. Limited results of group self-management education for rheumatoid arthritis patients and their partners: explanations from the patient perspective. Clinical Rheumatology, July 18, 2008.