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- Title
Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial.
- Authors
Kurniasari, Maria Dyah; Monsen, Karen A.; Weng, Shuen Fu; Yang, Chyn Yng; Tsai, Hsiu Ting
- Abstract
Background: Gout arthritis is an autoinflammatory arthritis that generates chronic long-term pain. Pain impacts physical activities, joint mobility, stress, anxiety, depression, and quality of life. Cold-water immersion therapy reduces inflammation and pain associated with gout arthritis. However, cold-water immersion therapy has not been conducted among people worldwide with gout arthritis. Objective: To investigate the cold-water immersion intervention on pain, joint mobility, physical activity, stress, anxiety, depression, and quality of life among acute gout patients. Methods: A community-based randomized control trial design with two parallel-intervention groups: a cold-water immersion group (20–30°C 20 minutes/day for 4 weeks) and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were recruited using a multi-stage sampling method and were randomly assigned using block randomization. A generalized estimating equation model was used to analyze the results (coef. β) and produce 95% confidence intervals (CIs). A path analysis was used to analyze mediating effects. Results: Significant pain alleviation (β = −2.06; −2.42), improved joint mobility (β = 1.20, 1.44), physical activity (β = 2.05,.59), stress (β = −1.25; −1.35), anxiety (β = −.62; −1.37), and quality of life (β = 5.34; 9.93) were detected after cold-water immersion at the second-week, and were maintained to the fourth-week time point, compared to pre-intervention and the control group. Depression (β = −1.80) had decreased by the fourth week compared to the pre-test and control group. Cold-water immersion directly mediated alleviation of pain (β = −.46, p ≤.001) and to promote the quality of life (β =.16, p =.01). Conclusions: Cold-water immersion decreased pain, stress, anxiety, and depression, and increased joint mobility, physical activity, and quality of life. It mediated alleviation of pain to increase the quality of life.
- Subjects
INDONESIA; GOUT treatment; PHYSICAL diagnosis; STRUCTURAL equation modeling; IMMERSION in liquids; PAIN; CONFIDENCE intervals; RANGE of motion of joints; COLD therapy; WATER; COMMUNITIES; VISUAL analog scale; MEASUREMENT of angles (Geometry); HEALTH surveys; PHYSICAL activity; RANDOMIZED controlled trials; PSYCHOLOGICAL tests; CRONBACH'S alpha; QUALITY of life; MENTAL depression; SCALE analysis (Psychology); QUESTIONNAIRES; DESCRIPTIVE statistics; RESEARCH funding; ANXIETY; STATISTICAL sampling; STATISTICAL models; PATH analysis (Statistics); BLOOD pressure measurement; BODY mass index; DATA analysis software; PSYCHOLOGICAL stress
- Publication
Biological Research for Nursing, 2022, Vol 24, Issue 2, p245
- ISSN
1099-8004
- Publication type
Article
- DOI
10.1177/10998004211063547