The Effectiveness of Self-Help Groups in Enhancing Self-Efficacy Among Patients with Gout Arthritis in the Sangihe Islands Community, Indonesia
DOI:
https://doi.org/10.70716/mohr.v4i3.648Keywords:
arthritis, gout, health education, self-efficacy, self-help groupsAbstract
Community in island settings has limited access to healthcare facility as well as health information. Nevertheless, the strong kinship networks and social cohesion characteristic represent valuable sociocultural resources. This study aimed to evaluate the effectiveness of Self-Help Group (SHG) on self-efficacy among patients with gout arthritis living in the Sangihe Islands Regency, rural and remote archipelagic area located at the Indonesia-Philippines border. A quasi-experimental design with pretest-posttest control group was conducted on September-November 2025, involving 134 participants (74 intervention, 60 control). Self-efficacy was measured using the validated and reliable Indonesian version of the Arthritis Self-Efficacy Scale-8 (ASES-8). The intervention group received a single 45-60 minutes session (8 groups), Baseline groups were comparable in age, gender and employment, but differed in duration of illness and education level; both were controlled as covariates in analysis. The intervention group showed a significant increase in self-efficacy from pre-test (media=21.5) to post-test (median=68.5) (Wilcoxon test, p=0.001). Post-intervention self-efficacy was significantly higher in the intervention group (mean=67.61; median 68.5) compared to the control group (mean=41.18; median 39) (Mann-Whitney test, p=0.001). After adjusting for duration of illness and education level, the intervention effect remained highly significant (ANCOVA, F=173.56; p<0.001), with no significant covariate or interaction effects. These findings emphasize The SHG Method can increase self-efficacy among patients with gout arthritis. This low-cost, community-based method is recommended for integration into routine health education at community health centers to enhance chronic disease self-management in island and remote settings.Community in island settings has limited access to healthcare facility as well as health information. Nevertheless, the strong kinship networks and social cohesion characteristic represent valuable sociocultural resources. This study aimed to evaluate the effectiveness of Self-Help Group (SHG) on self-efficacy among patients with gout arthritis living in the Sangihe Islands Regency, rural and remote archipelagic area located at the Indonesia-Philippines border. A quasi-experimental design with pretest-posttest control group was conducted on September-November 2025, involving 134 participants (74 intervention, 60 control). Self-efficacy was measured using the validated and reliable Indonesian version of the Arthritis Self-Efficacy Scale-8 (ASES-8). The intervention group received a single 45-60 minutes session (8 groups), Baseline groups were comparable in age, gender and employment, but differed in duration of illness and education level; both were controlled as covariates in analysis. The intervention group showed a significant increase in self-efficacy from pre-test (media=21.5) to post-test (median=68.5) (Wilcoxon test, p=0.001). Post-intervention self-efficacy was significantly higher in the intervention group (mean=67.61; median 68.5) compared to the control group (mean=41.18; median 39) (Mann-Whitney test, p=0.001). After adjusting for duration of illness and education level, the intervention effect remained highly significant (ANCOVA, F=173.56; p<0.001), with no significant covariate or interaction effects. These findings emphasize The SHG Method can increase self-efficacy among patients with gout arthritis. This low-cost, community-based method is recommended for integration into routine health education at community health centers to enhance chronic disease self-management in island and remote settings.
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References
Abhishek, A., & Doherty, M. (2018). Education and non-pharmacological approaches for gout. Rheumatology, 57(1), i51–i58. https://doi.org/10.1093/rheumatology/kex421
Audina, K., Yaqin Salam, A., & Yunita, R. (2024). The relationship between self-efficacy and attitudes and behaviors in preventing uric acid complications in Maron Wetan Village, Maron Subdistrict, Probolinggo Regency. Jurnal Ilmu Kesehatan Mandira Cendikia, 3(8), 131–142. https://journal-mandiracendikia.com/jikmc
Caetano, R. (2004). Standards for reporting non-randomized evaluations of behavioral and public health interventions: The TREND statement. Addiction, 99(9), 1075–1080. https://doi.org/10.1111/j.1360-0443.2004.00785.x
Cameranesi, M., Mollard, R., Balshaw, R., & MacKay, D. (2023). The Hans Kai trial: Study protocol of a mixed methods randomized controlled trial evaluating a peer-led health promotion program for adults with or without noncommunicable diseases. Trials, 24(689), 1–19. https://doi.org/10.1186/s13063-023-07708-z
Chen, J., Tian, Y., Yin, M., Lin, W., Tuersun, Y., Li, L., Yang, J., Wu, F., Kan, Y., Li, X., Gan, Y., Sun, X., Wu, Y., & He, F. (2023). Relationship between self-efficacy and adherence to self-management and medication among patients with chronic diseases in China: A multicentre cross-sectional study. Journal of Psychosomatic Research, 164, 111105. https://doi.org/10.1016/j.jpsychores.2022.111105
Chingono, R., Kasese, C., Miles, S., & Busza, J. (2022). ‘I was in need of somewhere to release my hurt:’ Addressing the mental health of vulnerable adolescent mothers in Harare, Zimbabwe, through self-help groups. Global Health Action, 15(1). https://doi.org/10.1080/16549716.2022.2040151
Constantini, J., Bliem, H. R., Crepaz, M., & Marksteiner, J. (2023). A qualitative literature search and pilot study of online support groups for patients with dementia and their carers. Gerontology and Geriatric Medicine, 9, 1–9. https://doi.org/10.1177/23337214231205689
Dose, C., Roschmann, T., Kinnen, C., Rademacher, C., Hautmann, C., & Döpfner, M. (2024). Telephone-Assisted Self-Help for caregivers of adolescents with attention-deficit/hyperactivity disorder: an observational Proof-of-Concept Study. Journal of Child and Family Studies, 33(6), 1752–1767. https://doi.org/10.1007/s10826-024-02831-0
Eze, C. C., Ekeke, N., van Brakel, W., Ossai, E. N., Henry, P., Onyima-Esmai, A., Nwafor, C. C., Murphy-Okpala, N., Meka, A., Ezeakile, O., Njoku, M., Iyama, F. S., Anyaike, C., Egbule, D., & Chukwu, J. (2025). Evaluating effectiveness of self-help groups in reduction of stigma in patients with neglected tropical diseases in Southern Nigeria: A cluster randomised study. Plos One, 20(10 October), 1–17. https://doi.org/10.1371/journal.pone.0327741
Farahimanesh, S., Serino, S., Tuena, C., Di Lernia, D., Wiederhold, B. K., Bernardelli, L., Riva, G., & Moradi, A. (2023). Effectiveness of a Virtual-Reality-Based Self-Help Intervention for Lowering the Psychological Burden during the COVID-19 Pandemic: Results from a Randomized Controlled Trial in Iran. Journal of Clinical Medicine, 12(5), 1–14. https://doi.org/10.3390/jcm12052006
Fields, T. R., & Batterman, A. (2018). How can we improve disease education in people with gout? Current Rheumatology Reports, 20(12), 1–9. https://doi.org/10.1007/s11926-018-0720-x
FitzGerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A. M., Gelber, A. C., Harrold, L. R., Khanna, D., King, C., Levy, G., Libbey, C., Mount, D., Pillinger, M. H., Rosenthal, A., Singh, J. A., Sims, J. E., Smith, B. J., Wenger, N. S., … Neogi, T. (2020). 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis and Rheumatology, 72(6), 879–895. https://doi.org/10.1002/ART.41247/ABSTRACT
Granat, L., Andersson, S., Hadziabdic, E., Brännström, M., Sandgren, A., Brannstrom, M., & Sandgren, A. (2022). Translation, adaptation, and validation of the Self-efficacy in Palliative Care scale (SEPC) for use in Swedish healthcare settings. BMC Palliative Care, 21(48), 1–11. https://doi.org/10.1186/s12904-022-00940-5
Heisler, M., Dyer, W. T., Finertie, H., Stoll, S. C., Wiley, D., Turner, C. D., Sedgwick, T., Kullgren, J., Richardson, C. R., Hedderson, M., & Schmittdiel, J. A. (2024). Using Peer Support to Aid in Prevention and Treatment in Prediabetes (UPSTART): Results of a pragmatic randomized controlled trial. HHS Pubic Access, 65(2), 239–250. https://doi.org/10.1016/j.amepre.2023.02.015
Indonesia Rheumatology Association. (2018). Diagnosis and Gout Management. Indonesia Rheumatology Association. https://reumatologi.or.id/wp-content/uploads/2020/10/Rekomendasi_GOUT_final.pdf
Januarti, L. F., Soliha, S., & Yulianto, S. (2024). Effectiveness of the Self-Help Group (SHG) method on blood pressure in productive women with hypertension. International Journal of Nursing and Midwifery Science (IJNMS), 8(2), 190–196. https://doi.org/10.29082/ijnms/2024/vol8/iss2/597
Kim, J. H., Kim, K. Y., Lee, S. J., Bae, S. G., Ryu, D. H., & Lee, W. K. (2017). A study on sustainability of knowledge, self care behavior, and self-efficacy after self-help group program for hypertension and diabetes. Journal of Health Informatics and Statistics, 42(3), 276–284. https://doi.org/10.21032/jhis.2017.42.3.276
Klaw, E., & Luong, D. (2010). Self‐Help Groups. In I. Weiner & E. Craighead (Eds.), The Corsini Encyclopedia of Psychology (4th ed., pp. 1538–1540). John Wiley & Sons, Inc. https://doi.org/10.1002/9780470479216.CORPSY0838
Kulsum, U., Ulfa, M., & Wicaksono, K. E. (2021). Impact of self-help groups on patients’ knowledge in chronic disease management. Media Husada Journal of Nursing Science, 2(1), 64–69. https://doi.org/10.33475/mhjns.v1i2.15
Mahato, T., & Jha, M. K. (2024). Does participation in self-help group affect the psychological empowerment of tribal women? Evidence from India. International Journal of Development Issues, 23(3), 447–462. https://doi.org/10.1108/IJDI-11-2023-0265
Manning, A., Pollock, M. D., Gopisetty, N., Linder, B., Misiewicz, R., Girdwood, T., Matsuura, M., Elliot, J. N., Maslow, G., & Docherty, S. (2025). The effects of serving as a peer supporter on adolescents and young adults with chronic conditions: A scoping review. Health Care Transitions, 3(100103), 1–15. https://doi.org/10.1016/j.hctj.2025.100103
Manvar, H. A., Kathiriya, J. B., & Thakar, D. S. (2019). Role of self help groups in women empowerment and health. International Journal of Current Microbiology and Applied Sciences, 8(4), 1613–1617. https://doi.org/10.20546/ijcmas.2019.804.187
Mehrmann, L. M., & Gerlach, A. L. (2024). The challenge for successful Self-Help: Side effects of discontinuing an Internet-Based Program for skin picking disorder. Cognitive Therapy and Research, 48(1), 39–51. https://doi.org/10.1007/s10608-023-10430-4
Melisse, B., van den Berg, E., de Jonge, M., Blankers, M., van Furth, E., Dekker, J., & de Beurs, E. (2023). Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy–Enhanced for Binge Eating Disorder: Randomized Controlled Trial. Journal of Medical Internet Research, 25(e40472), 1–19. https://doi.org/10.2196/40472
Micklitz, H. M., Nagel, Z., Jahn, S., Oertelt-Prigione, S., Andersson, G., & Sander, L. B. (2023). Digital self-help for people experiencing intimate partner violence: a qualitative study on user experiences and needs including people with lived experiences and services providers. BMC Public Health, 23(1), 1–15. https://doi.org/10.1186/s12889-023-16357-5
Ministry of Health, R. of I. (2018). Basic Health Research of Indonesia (Riskesdas). In Riskesdas. https://layanandata.kemkes.go.id/katalog-data/riskesdas/ketersediaan-data/riskesdas-2013
Neogi, T., Jansen, T. L. T. A., Dalbeth, N., Fransen, J., Schumacher, H. R., Berendsen, D., Brown, M., Choi, H., Edwards, N. L., Janssens, H. J. E. M., Lioté, F., Naden, R. P., Nuki, G., Ogdie, A., Perez-Ruiz, F., Saag, K., Singh, J. A., Sundy, J. S., Tausche, A. K., … Taylor, W. J. (2015). 2015 Gout Classification Criteria: An American College of Rheumatology/European League Against Rheumatism Collaborative Initiative. Arthritis and Rheumatology, 67(10), 2557–2568. https://doi.org/10.1002/art.39254
Oroh, C. T. M., Suprapti, F., & Susilo, W. H. (2020). Improving self-efficacy and life activities of arthritis patients: A quasi-experiment study. Enfermeria Clinica, 30, 30–33. https://doi.org/10.1016/j.enfcli.2020.07.006
Rohloff, N., Götz, T., Kortekamp, S. S., Heinze, N. R., Weber, C., & Schäfer, S. D. (2024). Influence of App-Based Self-Management on the quality of life of women with endometriosis. Cureus, 16(8), 1–11. https://doi.org/10.7759/cureus.67655
Sandehang, C. F., Handayani, D., Hayati, Y. S., Kristianingrum, N. D., Kumboyono, K., & Kartika, A. W. (2023). Improving self-efficacy of gout arthritis sufferers with self-help group. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 8(1), 513–518. https://doi.org/10.30604/jika.v8i1.1612
Sulistyowati, E. C., & Sulistyowati, D. (2019). Empowering patients through self-help groups: changes in coping mechanisms among schizophrenia patients at Dr. Arif Z Mental Hospital, Surakarta. Jurnal Terpadu Ilmu Kesehatan, 8(1), 94–100. https://doi.org/10.37341/interest.v8i1.123
van der Ven, J., van den Bemt, B. J. F., Flendrie, M., Vriezekolk, J. E., & Verhoef, L. M. (2025). Determinants of self-management behavior in gout: A scoping review. Arthritis Care and Research, 77(4), 534–544. https://doi.org/10.1002/acr.25449
Weaver, J. S., Vina, E. R., Munk, P. L., Klauser, A. S., Elifritz, J. M., & Taljanovic, M. S. (2022). Gouty arthropathy: Review of clinical manifestations and treatment, with emphasis on imaging. Journal of Clinical Medicine, 11(166), 1–28. https://doi.org/https://doi.org/ 10.3390/jcm11010166
Wu, C.-J. (Jo), Poulter, R., Atherton, J. J., MacIsaac, R. J., Leung, T. Y., Hung, P. C. K., & Ramis, M.-A. (2025). A qualitative exploratory study of user experience with a peer-support based, self-management website for people with a cardiovascular condition and diabetes. Digital Health, 11, 1–11. https://doi.org/10.1177/20552076251350927
Xu, H., Liu, M., Bai, Y., Yang, J., Liu, Y., Gao, X., Cieza, A., & Wu, J. (2025). Community-integrated noncommunicable disease service models: lessons from China. Journal of Global Health, 15(04296), 1–19. https://doi.org/10.7189/jogh.15.04296
Zhong, X., Li, S., Luo, M., Ma, X., & Fisher, E. B. (2023). Peer support self-management intervention for individuals with type 2 diabetes in rural primary care settings: Protocol for a mixed methods study. JMIR Research Protocols, 12(e47822), 1–9. https://doi.org/10.2196/47822
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