Hormone Therapy

Effects of an action research-based nursing program on rheumatoid arthritis patients on long-term hormone therapy: A randomized controlled trial.

TL;DR

An action research-based nursing program significantly enhances compliance and joint mobility, controls blood glucose increases, and reduces pain, anxiety, and depression in RA patients on long-term hormone therapy compared to conventional care.

Key Findings

Both groups showed no significant baseline differences across all measured outcomes prior to intervention.

  • 80 RA patients were recruited from January 1, 2023 to May 31, 2024 from the Department of Rheumatology and Immunology
  • Patients were randomized into two groups of 40 each: control (conventional care) and intervention (action research-based nursing program)
  • Baseline measurements showed no significant differences between groups in fasting blood glucose, 2-hour postprandial blood glucose, pain, joint mobility, and anxiety and depression scores (P > .05)
  • This confirms comparability between groups prior to intervention

The intervention group showed significantly smaller increases in both fasting and 2-hour postprandial blood glucose compared to the control group following long-term hormone therapy.

  • Blood glucose was measured daily via fasting and 2-hour postprandial readings
  • Long-term hormone therapy is associated with blood glucose elevations, which the action research-based program appeared to attenuate
  • The intervention group demonstrated significantly smaller increases in fasting blood glucose than the control group post-intervention
  • The intervention group demonstrated significantly smaller increases in 2-hour postprandial blood glucose than the control group post-intervention

The intervention group showed significantly greater improvements in patient compliance compared to the control group.

  • Compliance was assessed via a self-developed compliance scale with established reliability and validity
  • Both groups exhibited improvements in compliance post-intervention
  • The intervention group showed significantly greater improvements in compliance than the control group
  • Improved compliance is a key outcome of the action research-based nursing approach

The intervention group showed significantly greater reductions in pain compared to the control group.

  • Pain was assessed using a Visual Analog Scale (VAS)
  • Both groups exhibited improvements in pain scores post-intervention
  • The intervention group showed significantly greater improvements in pain compared to the control group
  • Baseline pain scores showed no significant difference between groups (P > .05)

The intervention group showed significantly greater improvements in joint mobility compared to the control group.

  • Joint activity was assessed using the 28-joint Disease Activity Score (DAS28)
  • Both groups exhibited improvements in joint mobility post-intervention
  • The intervention group showed significantly greater improvements in joint mobility than the control group
  • Baseline joint mobility scores showed no significant difference between groups (P > .05)

The intervention group showed significantly greater reductions in anxiety and depression compared to the control group.

  • Anxiety and depression were assessed using self-rating scales
  • Both groups exhibited improvements in anxiety and depression scores post-intervention
  • The intervention group showed significantly greater improvements in anxiety and depression compared to the control group
  • Baseline anxiety and depression scores showed no significant difference between groups (P > .05)

The action research-based nursing program was implemented as a structured intervention within a randomized controlled trial design.

  • The study used a randomized controlled trial design with 80 participants across two sites/groups
  • The control group received conventional care while the intervention group received care based on the action research method
  • The study period ran from January 1, 2023 to May 31, 2024
  • Evaluations included daily measurements of fasting and 2-hour postprandial blood glucose, along with periodic assessments of compliance, pain, joint activity, and psychological status
  • The authors describe this method as providing 'a practical reference for clinical nursing intervention' in RA patients on long-term hormone therapy

What This Means

This research suggests that a structured nursing approach called 'action research-based nursing' can meaningfully improve the health and wellbeing of patients with rheumatoid arthritis (RA) who need to take hormones (corticosteroids) over a long period. The study compared 40 patients receiving this specialized nursing program to 40 patients receiving standard care over about 17 months. The specialized program led to better patient compliance with their treatment, less pain, better joint movement, lower anxiety and depression, and smaller rises in blood sugar — a known side effect of long-term hormone use. One of the more practically significant findings is that the action research-based nursing program appeared to help control blood sugar increases that typically occur with long-term corticosteroid therapy. Since elevated blood sugar is a serious complication of this type of treatment, nursing interventions that can mitigate this risk are clinically relevant. The program also addressed the psychological burden of living with a chronic condition, with patients in the intervention group experiencing greater reductions in both anxiety and depression. This research suggests that shifting from conventional nursing care to an action research-based approach — which involves ongoing assessment, planning, and refinement of care strategies — could offer meaningful benefits for RA patients on long-term hormone therapy. The authors propose this approach as a practical model for clinical nursing in this patient population, though further studies with larger samples and longer follow-up periods would help confirm and extend these findings.

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Citation

Sun L, Zhang Y, Huang H, Gu C. (2026). Effects of an action research-based nursing program on rheumatoid arthritis patients on long-term hormone therapy: A randomized controlled trial.. Medicine. https://doi.org/10.1097/MD.0000000000048643