Aims To examine the effects of a tailored telehealth educational intervention on medication adherence and disease activity in discharged patients with rheumatoid arthritis (RA). Design An un‐blinded randomized controlled trial. Methods A total of 92 eligible patients were recruited from January 2015–December 2015. Participants were randomly assigned to either the intervention (N = 46) or control group (N = 46). The intervention group received four educational sessions delivered through a telephone across a 12‐week intervention. The content of the education mainly included: subject's knowledge about disease; treatment goals; the importance of taking medication correctly; side effect management; remembering to take medication. The control group received only standard care including discharge instructions. Outcome measures included medication adherence and disease activity. Results The intervention group had significantly higher medication adherence compared with the control group at 12th and 24th week. There was no significant difference between two groups in disease activity at 12th and 24th week. Conclusions The telephone‐delivered tailored educational intervention effectively improved medication adherence among discharged patients with rheumatoid arthritis. However, no significant benefits of the intervention on disease activity were detected. Impact Good medication adherence in rheumatoid arthritis patients contributes to controlling symptom and inflammation, preventing the progressive structural damage. This study demonstrated that the telehealth educational intervention could improve patients' medication adherence but did not have a direct impact on clinical condition in the short‐term. The intervention for discharged patients with rheumatoid arthritis can be integrated into the clinical setting by the nursing staff as follow‐up care. Trial registration number: ChiCTR‐IPR‐14005722.

Occupational stress impairs nurses’ psychosomatic wellbeing, which includes anxiety, depression, sleep quality, and somatic symptoms; however, few studies have focused on the associations between the subdimensions of occupational stress [workload and time pressure (WTP), professional and career issues (PC), patient care and interaction (PCI), interpersonal relationships and management problems (IRMP), resource and environment problem (REP)] and psychosomatic wellbeing among nurses in China. This study thus examined these associations using a cross-sectional survey in Sichuan, China. An online application was devised to collect data, with the scales of sociodemographic and occupational variables, Nurse Job Stressor Questionnaire, the 9- and 15-item Patient Health Questionnaires, the 7-item Generalized Anxiety Disorder scale, and the Pittsburgh Sleep Quality Index. Investigation was completed by 2889 nurses (96.7% women; mean age = 31.20 ± 6.72 years). Relationships were identified by correlation and multivariate regression analyses. Most (68.3%) nurses had high levels of occupational stress. The multivariate analyses revealed that WTP was correlated with anxiety ( P = .003). PC was associated with depression ( P = .033) and sleep quality ( P = .078). PCI was correlated with anxiety ( P = .031) and somatic symptoms ( P = .005). IRMP was associated with anxiety ( P = .018), depression ( P = .001), and somatic symptoms ( P = .025). Lastly, REPs had nonsignificant relationships with depression, anxiety, sleep quality, and somatic symptoms. In sum, nurses had high levels of occupational stress; therefore, a series of strategies should be implemented to help nurses cope with the above issues, which could promote nurses’ psychosomatic wellbeing, and have a buffering effect on nurses’ depression, anxiety, poor sleep quality, and somatic symptoms.

Aims and objectives To explore the effectiveness of a health education programme by telephone follow‐up on the self‐efficacy of patients with rheumatoid arthritis (RA). Background Self‐efficacy is increasingly perceived to be a cornerstone in improving the capacity of self‐management. However, a paucity of research has demonstrated the effectiveness of health education by the use of a telephone follow‐up for RA patients in China. Design This study was a randomised control trial. Methods Recruited patients were randomly divided into control and intervention groups. The intervention group accepted health education by telephone follow‐up four times after the patients were discharged. The patients in the control group only accepted telephone follow‐up once after they were discharged. Self‐efficacy was measured by the use of the Rheumatoid Arthritis Self‐Efficacy Questionnaire (RASE), and data were collected at the day before the discharge, the 12th week and the 24th week after patients were discharged. The CONSORT checklist was used to check the procedure. Results A total of 92 discharged patients with rheumatoid arthritis were enrolled. The sociodemographic indexes of the control and intervention groups had no significant differences at baseline (p > .05). The RASE score of the intervention group was higher than that of the control group (p < .05) at the 12th week and the 24th week. Conclusion The HET improved the self‐efficacy of the discharged patients with RA in the 12th week and the 24th week after discharge. This study demonstrated that our HET can improve the short‐term and long‐term effects of self‐efficacy, which implies that the clinical nursing staff should increase the frequency of HET to improve the patients’ knowledge and abilities of self‐management. Relevance to clinical practice Patients with RA will benefit from a health education programme by telephone follow‐up; thus, it is necessary for nursing managers to implement this programme.

With the rising number of patients with rheumatoid arthritis (RA), there is a limited understanding about sociodemographic factors that influence functional disability in Chinese patients. In order to provide more targeted interventions to improve health-related quality of life (HRQoL) for patients with RA, we conducted a cross-sectional study to investigate the level and influencing factors of functional disability. Convenient samples were collected in outpatients with RA from a rheumatological center in southwest China from September to December 2013. Data were collected by printed questionnaires, and functional disability was measured by the Health Assessment Questionnaire Disability Index (HAQ-DI). The results showed that 58.48 % of 607 outpatients had functional disability. Patients from rural residents, with lower household income and lower education level, were significantly associated with worse functional disability. Multivariate regression findings showed that pain, age, disease duration, total cost for treatment, and frequency of hospitalization were positively associated with functional disability. Meanwhile, subjective and available social support was the protective predictors for functional disability. The results suggested that systematic intervention and therapies should be provided as early as possible. Patients and health care providers should promote the awareness of the importance of accessible health education in early intervention of RA. Besides, pain management and social support are encouraged to postpone the process of disability of patients and improve the HRQoL. Lastly, but not least, prevention and intervention of RA should be incorporated into public health education.