The value of health education including motivational psychology elements for patients with osteoarthritis of the hip and knee- a prospective randomized comparison of two strategies

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Background: Patient education is key in the management of chronic musculoskeletal diseases like osteoarthritis (OA) of the hip and/or knee. Comparatively few studies provide information on the content of educational programs and their specific impact on patient-related parameters such as self-efficacy. The objective of this study was to evaluate the effect of two single-session educational trainings containing different motivational psychology elements. Methods: Two different types of educational training conveying the same information were designed as a one-time intervention. Training A was designed according to the Health Action Process Approach (HAPA). Training B included motivational elements based on positive images. Patients with OA of the hip or knee were randomly assigned to participate in either Training A or Training B. The patients completed questionnaires at baseline, directly after the training and 16 weeks after the training. The main evaluated parameters were disease-specific knowledge, assessed by two different questionnaires, pain-related self-efficacy and OA symptoms (WOMAC score). Results: Fifty-two patients participated. Of these, 27 were assigned to group A and 25 to group B. Disease-specific knowledge improved significantly in both groups immediately after the training and at 16 weeks follow-up. Self-efficacy was initially enhanced in both groups after the trainings but a significant improvement at 16 weeks follow-up was only found for group A. The increase in self-efficacy scores after 16 weeks was significantly higher in group A than in group B. There was a trend towards improved WOMAC scores after 16 weeks for group A but not for group B. Conclusion: The results indicate that disease-specific knowledge of OA patients can be enhanced by one-time educational trainings including motivational psychology elements. A HAPA-based training could possibly also lead to lasting improvements regarding patients’ self-efficacy and OA-related symptoms. Thus HAPA-based educational programs seem to be a promising, feasible tool to improve OA patients’ self-care. Trial registration: The study was registered with the German Clinical Trials Register (DRKS00021827).