Rheumatoid arthritis : a cognitive-behavioural intervention

This study investigated both the mediating role of psychological adjustment in determining pain experience, disease · status, and immune function in Rheumatoid Arthritis (RA), and the value of cognitive-behavioural intervention in improving the overall health status of such patients. Two related hypotheses were tested in a matched-random assigned two-groups design, with pre-, mid-, and post-intervention assessment. Fourteen (N = 14) female RA outpatients, selected along established inclusion criteria, were allocated to either treatment (n=8) or control (n=6) groups after being matched on date of disease onset and ratings, of coping efficacy. The treatment group received an eight week Stress Inoculation and Pain Management Training programme (sixteen 2-hour sessions) based on the conceptual approach of Meichenbaum (1985) and adopted from a program by O'Leary, Shoor, Lorig and Holman (1988). The program included educational material, instruction in palliative and cognitive pain management strategies and the application thereof in daily living, goal setting to improve activity function, and group discussion. The program was designed to nurture and develop existing coping skills, and to impart new strategies to cope with daily stress and pain. Pre-intervention correlational analyses tested the extent to which mood disturbance, self-perceptions of coping efficacy, health locus of control and stressful life experience were related to intensity and quality of pain, disease activity, functional status and lymphocyte proliferation rate. Intra- and inter-group analyses were conducted to determine treatment effects in terms of change scores .on the dependent measures, and case studies were conducted to evaluate individual response both to disease and cognitive-behavioural intervention.

Grantor dc:publisher.institution

Department of Psychology

Year dc:date.issued

1991

Author dc:creator

• Germond, Sean Alan

Advisor dc:contributor.advisor

• Schomer, Helgo

Language dc:language.iso

eng

Handle dc:identifier.uri

http://hdl.handle.net/11427/13551

OAI identifier oai:identifier

oai:open.uct.ac.za:11427/13551