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Journal of Integrative Nursing ›› 2024, Vol. 6 ›› Issue (1): 22-28.doi: 10.4103/jin.jin_141_23

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Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

Mohammed Elsayed ZAKY1, Shimaa Magdi FARGHALY2, Osama Mohamed Elsayed RAMADAN3, Rehab M. ABDELKADER1, Mostafa SHABAN4   

  1. 1Department of Medical Surgical Nursing, Faculty of Nursing Cairo University, Cairo, Egypt; 2Department of Medical Surgical Nursing, College of Nursing, Jouf University, Sakaka, Aljawf, Saudi Arabia; 3Faculty of Nursing Cairo University, Cairo, Egypt; 4Department of Geriatric Nursing, Faculty of Nursing Cairo University, Cairo, Egypt
  • Online:2024-03-27 Published:2024-03-29
  • Contact: Mohammed Elsayed ZAKY, Department of Medical Surgical Nursing, Faculty of Nursing Cairo University, Cairo, Egypt. E-mail: mohammed.zaky@cu.edu.eg

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Abstract:

Objective: Rheumatoid arthritis (RA) requires comprehensive management. Structured nursing protocols may enhance outcomes, but evidence is limited. This study evaluated the effect of a structured nursing protocol on RA outcomes.

Materials and Methods: In this one-group pre-post study, 30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education, psychosocial support, and self-management promotion. Assessments included clinical evaluation of joint counts, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and patient-reported Arthritis Self-Efficacy Scale (ASES), Health Assessment Questionnaire (HAQ), Visual Analog Scale (VAS) for pain, and Hospital Anxiety and Depression Scale (HADS).
Results: The study demonstrated significant improvements in both clinical- and patient-reported outcomes. Joint count decreased from 18.4 ± 4.2 to 14.2 ± 3.8 (P < 0.001), ESR from 30.1 ± 6.8 mm/h to 25.5 ± 6.8 mm/h (P < 0.01), and CRP levels from 15.2 ± 3.6 mg/L to 11.8 ± 2.9 mg/L (P < 0.01) postintervention. Patient-reported outcomes showed a marked increase in ASES score from 140 ± 25 to 170 ± 30 (P < 0.001) and reductions in HAQ from 1.6 ± 0.4 to 1.3 ± 0.3 (P < 0.01), VAS pain score from 7.8 ± 1.7 to 6.2 ± 1.2 (P < 0.001), and HADS anxiety and depression scores from 11 ± 3 to 8 ± 2 (P < 0.05) and 10 ± 2 to 7 ± 1 (P < 0.05), respectively.
Conclusion: A structured nursing protocol significantly improved clinical disease activity, physical functioning, pain, self-efficacy, and emotional well-being in RA patients. A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

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