Patient Education In the Department of Medicine

Programa de Manejo Personal de la Artritis
(Spanish Arthritis Self-Management Program)

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Programa de Manejo Personal de la Artritis is a workshop given two hours, once a week, for six weeks, in community settings such as senior centers, churches, libraries and hospitals. Spanish-speaking people with different kinds of arthritis and other rheumatic diseases attend together. Workshops are facilitated by two trained Leaders, one or both of whom are non-health professionals with arthritis or other rheumatic disease themselves. All workshops are given in Spanish without translators.

The Program is not a translation of the Arthritis Self-Management Program, but developed separately in Spanish. Subjects covered are similar, but they are presented in ways that are culturally appropriate. Subjects include: 1) techniques to deal with problems such as pain, frustration, fatigue, and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) appropriate use of the health care system, and, 6) how to evaluate new and alternative treatments.

Each participant in the workshop receives a copy of the companion book, Cómo convivir con su artritis,* an audio relaxation tape, Casete de Relajación,* and an audio exercise tape with booklet, ¡Hagamos ejercicio!* All materials are in Spanish.

It is the process in which the program is given that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their arthritis and maintain active and fulfilling lives.

How was the Program developed?

The Department of Medicine in the School of Medicine at Stanford University received a number of research grants from the National Institute of of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The purpose of the research was to develop and evaluate, through a randomized controlled trial, a community-based Spanish-language self-management program that assists Latinos with arthritis. The study was completed 1998.

Principal investigator for the research project was Kate Lorig, Dr.P.H., Stanford Professor Emeritus of Medicine. The Program was written by Dr. Lorig, Virginia González, M.P.H., Virginia Nacif de Brey, and Maria Hernández Marin.

The process of the program was based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups in Spanish with people with arthritis, in which the participants discussed which content areas were the most important for them.

How was the Program evaluated?

Over 300 Spanish-speaking people with osteoarthritis or rheumatoid arthritis participated in a 4 month randomized, controlled test of the Program and were followed for longitudinally one year. We looked for changes in many areas: health status (disability, pain, fatigue, depression, self-rated general health), health care utilization (visits to physicians, visits to emergency department, hospital stays, and nights in hospital), self-efficacy (confidence to perform self-management behaviors, confidence to manage disease in general, confidence to achieve outcomes), and self-management behaviors (exercise, cognitive symptom management, mental stress management/relaxation).

What were the results?

Subjects who took the Program, when compared to those who did not, demonstrated improvements in disability, pain, and exercise.**

How can my facility offer the Program?

Organizations interested in offering the program need to purchase a program license (a link for the licensing information page is on the top right side of this page).

Trainings for Curso de Manejo Personal de la Artritis are not held at Stanford at this time. Any organization interested in adopting the Program should call or email Stanford Patient Education Research Center about scheduling a training at their own facility (800-366-2624 or self-manage-training@stanford.edu).

 

*For ordering information about Cómo convivir con su artritis, Casete de Relajación, and ¡Hagamos ejercicio!, see our materials page.

**Outcomes are reported in: Lorig K, González VM, and Ritter P. Community-based Spanish language arthritis education program: a randomized trial. Medical Care, 37(9):957-963,1999.

 

 

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