Background/Purpose:

Patients with rheumatoid arthritis (RA) often suffer from psychological problems, which may exacerbate pain and disease activity [1]. Bad emotional reaction to the diagnosis of RA contributes to the onset of depression symptoms [2]. However, hospitals cannot readily provide psychological support for patients because of insufficient specialists. Therefore, based on EULAR’s recommendations, nurses should acquire the necessary skills to provide psychological support in busy clinical settings.

The aim of this study is to assess if nurses who receive a single short training session from a clinical psychologist can attain confidence and competence in providing psychological support for patients.

Methods:

A clinical psychotherapist provided psychological support training to the participants only once for a period of one hour. This lecture was divided into 2 parts: (1) basic attitudes toward patients, such as “agreeableness”, “acceptance” and “empathic understanding”; (2) Solution Focused Approach (SFA), a new method in the RA field, consisting of the miracle, coping and scaling questions.

We evaluated nurses’ opinions regarding their confidence and competence in providing psychological support for patients by utilizing a 0-10 scale (0 = none, 10 = full agreement). Participants were asked regarding the necessity and feasibility of psychological support by nurses and their motivation for training. Client Satisfaction Questionnaire-8 (CSQ-8J) was utilized to assess satisfaction with the lecture; while the General Self-Efficacy Scale(GSES)was used to evaluate self-efficacy of nurses. Data analyses were performed with the Paired t-test and Wilcoxon rank sum test.

Results: Nurses involved in treatment of patients with RA were selected randomly between May and June, 2015. 55 nurses (0 male/ 55 female) were included in this study. The average of ages, clinical experience and clinical experience in RA were 42.4 years old, 17.8 and 5.8 years, respectively. Agreement about necessity and motivation was high and there were no statistically significant differences before and after the lecture (mean±SD; necessity: 9.55±1.07, 9.43±1.36, respectively, p=0.591, motivation: 9.24±1.4, 9.14±1.74, respectively, p=0.481). However, agreement regarding feasibility after the lecture was statistically significantly higher than that before the lecture (mean±SD; 7.88±2.07, 7.16±2.19, respectively, p<0.05). Nurses showed high levels of satisfaction with the lecture. The only question for which satisfaction was low concerned short length and lack of more detailed explanations. There were no statistically significant differences in nurses’ evaluations of self-efficacy before and after the lecture.

Conclusion: This is the first study indicating that even short training may be helpful in providing nurses with psychological support and SFA skills. This strategy could be appropriate in busy clinical settings. Further studies of repeated training and of nurses’ application of the skills acquired in such training are ongoing.

References:

[1] Rathbun AM, et al. Rheumatology (Oxford) 2013; 52: 1785-94.

[2] Sheehy C, et al. Rheumatology (Oxford) 2006; 45: 1325-7.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-short-training-on-solution-focused-approach-may-be-helpful-in-providing-psychological-support-skills-to-nurses-involved-in-rheumatoid-arthritis/