Randomized Controlled Trial
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2021; 9(28): 8413-8424
Published online Oct 6, 2021. doi: 10.12998/wjcc.v9.i28.8413
Effect of family caregiver nursing education on patients with rheumatoid arthritis and its impact factors: A randomized controlled trial
Jing Li, Ying Zhang, Ya-Juan Kang, Nan Ma
Jing Li, Ying Zhang, Ya-Juan Kang, Nan Ma, Department of Immunology and Rheumatology, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei Province, China
Author contributions: All authors made substantial contributions; Li J and Zhang Y designed the study; Zhang Y, Kang YJ and Ma N conducted the intervention and collected the data; all authors were involved in the data analysis; Li J and Zhang Y drafted the article; Kang YJ and Ma N revised it critically; All authors agreed to the content of the manuscript and approved the final version for submission.
Supported by Key Project of Medical-Science Research of Hebei Province, No. 20180432.
Institutional review board statement: The study was reviewed and approved by the Third Hospital of Hebei Medical University Institutional Review Board (No. 2016-KY1086).
Clinical trial registration statement: Not applicable.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: Technical appendix, statistical code and dataset available from the corresponding author at jinglijingli0311@163.com. Participants gave informed consent for data sharing.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Li, RN, Nurse, Department of Immunology and Rheumatology, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang 050051, Hebei Province, China. jinglijingli0311@163.com
Received: March 22, 2021
Peer-review started: March 22, 2021
First decision: May 11, 2021
Revised: May 12, 2021
Accepted: August 16, 2021
Article in press: August 16, 2021
Published online: October 6, 2021

Rheumatoid arthritis (RA) is a common autoimmune disease. Nursing education for family caregivers is considered a workable and effective intervention, but the validity of this intervention in RA has not been reported.


To explore whether family caregiver nursing education (FCNE) works on patients with RA and the factors that influence FCNE.


In this randomized controlled study, a sample of 158 pairs was included in the study with 80 in the intervention group and 78 in the control group. Baseline data of patients and caregivers was collected. The FCNE intervention was administered to caregivers, and inflammation level indicators, disease activity indicators and mood disorder indicators of patients were followed up and analyzed.


Baseline characteristics of the intervention and the control groups had no significant difference. Indicators were significantly reduced in the intervention group compared to the control group. The intervention group showed significant differences in stratification of relationship, education duration and age.


The effect of FCNE on RA is multifaceted, weakening inflammation level, alleviating disease activity and relieving mood disorder. Relationship between caregiver and patient, caregiver’s education level and patient’s age may act as impact factors of FCNE.

Keywords: Nursing education, Family nursing, Rheumatoid arthritis, Family caregivers, Depression, Anxiety

Core Tip: Education for family caregivers is considered a workable and effective intervention, but the validity of this intervention in rheumatoid arthritis (RA) has not been reported. Therefore, we designed a health education program called family caregiver nursing education, a series of professional training courses for family caregivers that focused on care techniques of RA patients and main points of RA-related knowledge. We chose a total of nine characteristic indicators in terms of inflammation level, disease activity and mood disorder for a 6 mo intervention and follow-up to assess the effect of family caregiver nursing education on RA in multiple ways.