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Yang, M.L., Yang, M.Y., Liu, Y.Q., et al. (2025) A Review of the Application Scope of the Chronic Disease Trajectory Theory in Self-Management of Patients with Chronic Diseases. Evidence-Based Nursing, 11, 4846-4853. (In Chinese)

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• TITLE: Construction and Empirical Study of a Staged Nursing Management Protocol for Frail Patients with Rheumatoid Arthritis Based on the Chronic Disease Trajectory Model

  AUTHORS: Jinhua Liu

  KEYWORDS: Chronic Disease Trajectory Model, Rheumatoid Arthritis, Frailty, Staged Nursing, Delphi Method, Mixed-Methods Study

  JOURNAL NAME: Journal of Biosciences and Medicines, Vol.14 No.7, July 7, 2026

  ABSTRACT: Objective: To develop a dynamic staged nursing management protocol for frail patients with rheumatoid arthritis (RA) based on the Chronic Disease Trajectory Framework, and to verify its effectiveness and feasibility in clinical practice. Methods: A mixed-methods design was adopted, including cross-sectional survey, semi-structured qualitative interview, Delphi expert consultation, and empirical clinical study. The study timeline was adjusted to ensure logical consistency: cross-sectional survey (January-August 2023), qualitative study (September-October 2023), Delphi (November-December 2023), and empirical pilot (January-February 2024). Results: The final protocol contained 21 intervention items, covering acute phase (7 items), subacute phase (8 items), and stable phase (6 items). The expert authority coefficient was 0.94, and Kendall’s concordance coefficient ranged from 0.189 to 0.236 (P Conclusion: The staged nursing protocol accurately matches the dynamic needs of frail RA patients across different disease phases, significantly improves physical function and quality of life, and provides a standardized, replicable tool for clinical nursing practice.