Self‐management support for patients with chronic disease: potential and questions

2018 ◽  
Vol 208 (2) ◽  
pp. 66-67
Author(s):  
Nicholas A Zwar ◽  
Sarah M Dennis
2016 ◽  
Vol 57 (03) ◽  
pp. e33-e33
Author(s):  
S. Zanoni ◽  
E. Gabriel ◽  
C. Salis Gross ◽  
M. Deppeler ◽  
J. Haslbeck

Erratum Zanoni S, Gabriel E, Salis Gross C, Deppeler M, Haslbeck J. Selbstmanagementförderung bei chronischer Krankheit für Menschen mit Migrationshintergrund – ein Gruppenkurs mit Peer-Ansatz als Beitrag zu gesundheitlicher Chancengerechtigkeit. Gesundheitswesen 2016; Bei diesem Beitrag wurde der engl. Titel korrigiert. Korrekt ist: Chronic Disease Self-management Support for People with a Migrant Background: towards a Peer-led Group Program to Improve Equity in Health


2020 ◽  
Vol 37 (6) ◽  
pp. 839-844
Author(s):  
Muhammad Danial Hadi ◽  
Yongxing Patrick Lin ◽  
Ee-Yuee Chan

Abstract Background Chronic diseases continue to be a significant cause of morbidity and mortality despite modifiable risk factors. This suggests that current primary healthcare provision needs to delve beyond patient education, to understand the motivators that drive patients to undertake chronic disease self-management. Understanding these motivations within the context of a multi-cultural community can facilitate tailored support for chronic disease self-management. Objectives To explore the motivations behind effective chronic disease self-management in community dwelling adults in Singapore. Methods A qualitative descriptive study was carried out in five clinics in a large medical centre. Twelve participants who were assessed to be optimally managing their chronic diseases were recruited using purposive sampling. Individual in-depth interviews were conducted until data saturation, with data thematically analysed. Results Three salient themes emerged from the data. Firstly, ‘Regaining self-control, avoiding complications’ describes the participants’ journey towards personal mastery in self-management, as well as a fear of debilitating complications resulting in their desire for good health. Secondly, ‘Preserving social identities and roles’ illustrates how participants yearn to maintain their pre-existing roles and functions through maintenance of their health. Finally, ‘Accessing proximal support systems’ highlights resources and supports surrounding the participants that encourage continued chronic disease self-management. Within each theme, specific motivators and challenges encountered by participants in their self-management journey were discussed. Conclusions Findings can prompt primary healthcare providers to leverage on the patients’ life goals and social roles in chronic disease self-management support. This may empower patients to engage in self-management and strengthen primary care provision.


2015 ◽  
Vol 2 ◽  
Author(s):  
Teresa J. Brady ◽  
Lynda A. Anderson ◽  
Rosemarie Kobau

2007 ◽  
Vol 31 (4) ◽  
pp. 499 ◽  
Author(s):  
Caitlin F Francis ◽  
Anne-Marie Feyer ◽  
Ben J Smith

The evaluation of the Sharing Health Care Initiative addressed the translation of different models of chronic disease self-management into health and community service contexts in Australia. Across seven projects, four intervention models were adopted: (1) the Stanford Chronic Disease Self Management course; (2) generic disease management planning, training and support; (3) tailored disease management planning, training and support, and; (4) telephone coaching. Targeted recruitment through support groups and patient lists was most successful for reaching high-needs clients. Projects with well developed organisational structures and health system networks demonstrated more effective implementation. Engagement of GPs in recruitment and client support was limited. Future self-management programs will require flexible delivery methods in the primary health care setting, involving practice nurses or the equivalent. After 12 months there was little evidence of potential sustainability, although structures such as consumer resource centres and client support clubs were established in some locations. Only one project was able to use Medicare chronic disease-related items to integrate self-management support into routine general practice. Participants in all projects showed improvements in self-management practices, but those receiving Model 3, flexible and tailored support, and Model 4, telephone coaching, reported the greatest benefits


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1285.1-1285
Author(s):  
A. Kocher ◽  
M. Simon ◽  
C. Chizzolini ◽  
O. Distler ◽  
A. A. Dwyer ◽  
...  

Background:People living with systemic sclerosis (SSc) often lack access to coordinated, specialized care and self-management support from qualified healthcare professionals. Such gaps lead to significant unmet health needs and inability to get preventive services. The Chronic Care Model (CCM) has been used to guide disease management across a wide range of chronic conditions. The CCM often uses e-health technologies to address self-management problems, connect patients with clinicians and reduce patient travel requirements.Objectives:To evaluate current SSc care practice patterns and elicit patient health technology readiness to define relevant aspects and resources needed to improve SSc chronic disease management.Methods:We employed a cross-sectional survey using the 20-item Patient Assessment of Chronic Illness Care (PACIC) instrument to assess how aspects of SSc care align with key components of the CCM.1Six items drawn from the ‘5A’ (ask, advise, agree, assist, and arrange) model of behavioural counselling were included (all 26 items scored on 5-point scale, 1=never to 5=always). Acceptance of health technology was evaluated by adapting and combining questionnaires from Vanhoof2and Halwas3. German and French speaking SSc patients (>18 years) were recruited from university/cantonal hospitals and the Swiss scleroderma patients’ association. Participants completed anonymous paper/online questionnaires. Data were analysed descriptively.Results:Of 101 SSc patients, most were female (76%), spoke German (78%) and had a median age of 60 years (IQR: 50-68). Median disease duration was 8 years (IQR: 5-15), spanning a range of severity (31% limited SSc, 36% diffuse SSc, 3% overlap syndrome). One-quarter (25%) did not know their disease subset.The mean overall PACIC score was relatively low (2.91±0.95) indicating that care was ‘never’ to ‘generally not’ aligned with the CCM. Lowest mean subscale scores related to Follow-up/ Coordination (2.64±1.02), Goal setting (2.68±1.07) and Problem-solving/Contextual Counselling (2.94±1.22). The single items ‘Given a copy of my treatment plan’ (1.99±1.38) and ‘Encouraged to attend programs in the community’ (1.89±1.16) were given the lowest ratings. The ‘5A’ summary score was 2.84±0.97.In terms of technology readiness, 43% completed the survey online. Most participants owned a smartphone (81%), laptop (63%) and/or desktop computer (46%). The overwhelming majority of patients (91%) reported using the Internet in the last year – primarily for communication (e.g. emails, text messages). Participants indicated relatively little experience with e-health applications and participating in SSc online forums or self-help groups.Conclusion:To improve chronic disease management of SSc patients in Switzerland, current care practices warrant reengineering taking CCM components into account. Specific unmet needs relate to self-management support, help patients set individualized goals, and coordinate continuous care. Web-based technologies incorporating user-centred design principles may be a reasonable option for improving care.References:[1]Glasgow, RE, et al. Development and validation of the Patient Assessment of Chronic Illness Care (PACIC).Med Care2005; 43(5): 436-44[2]Vanhoof, JM, et al. Technology Experience of Solid Organ Transplant Patients and Their Overall Willingness to Use Interactive Health Technology. J Nurs Scholarsh2018; 50(2): 151-62[3]Halwas, N, et al. eHealth literacy, Internet and eHealth service usage: a survey among cancer patients and their relatives. J Cancer Res Clin Oncol2017; 143(11): 2291-99Disclosure of Interests:Agnes Kocher Grant/research support from: Sandoz to support the development of an eLearning module for patients with rheumatic diseases., Michael Simon: None declared, Carlo Chizzolini Consultant of: Boehringer Ingelheim, Roche, Oliver Distler Grant/research support from: Grants/Research support from Actelion, Bayer, Boehringer Ingelheim, Competitive Drug Development International Ltd. and Mitsubishi Tanabe; he also holds the issued Patent on mir-29 for the treatment of systemic sclerosis (US8247389, EP2331143)., Consultant of: Consultancy fees from Actelion, Acceleron Pharma, AnaMar, Bayer, Baecon Discovery, Blade Therapeutics, Boehringer, CSL Behring, Catenion, ChemomAb, Curzion Pharmaceuticals, Ergonex, Galapagos NV, GSK, Glenmark Pharmaceuticals, Inventiva, Italfarmaco, iQvia, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Roche, Sanofi and UCB, Speakers bureau: Speaker fees from Actelion, Bayer, Boehringer Ingelheim, Medscape, Pfizer and Roche, Andrew A. Dwyer: None declared, Peter Villiger Consultant of: MSD, Abbvie, Roche, Pfizer, Sanofi, Speakers bureau: Roche, MSD, Pfizer, Ulrich Walker Grant/research support from: Ulrich Walker has received an unrestricted research grant from Abbvie, Consultant of: Ulrich Walker has act as a consultant for Abbvie, Actelion, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, MSD, Novartis, Pfizer, Phadia, Roche, Sandoz, Sanofi, and ThermoFisher, Paid instructor for: Abbvie, Novartis, and Roche, Speakers bureau: Abbvie, Actelion, Bristol-Myers Squibb, Celgene, MSD, Novartis, Pfizer, Phadia, Roche, Sandoz, and ThermoFisher, Dunja Nicca: None declared


2021 ◽  
Vol 33 (S1) ◽  
pp. 18-18
Author(s):  
Xiaoshan Rong ◽  
Fan Wu ◽  
Shuying Zhang

Background:Research found that caregivers of relatives with dementia(RWD)were more vulnerable to chronic diseases than those caring for relatives with other diseases. Unfamiliarity with and/or difficulty in balancing their own health needs was common among the caregivers, from the findings of our previous studies and relevant literatures. Therefore, an educational and psycho-social support program named Chronic Disease Self-Management Support (CD-SMS) program was developed for spouse caregivers of RWD in Shanghai, China.Research Objective:This study was to examine the effectiveness of the CD-SMS program on spouse caregivers’ health-related results, including caregiving self-efficacy, self-efficacy for chronic condition management, and their health behavior.Method:This study was a randomised, wait-list controlled design. A total of 53 participants with common chronic conditions were recruited and assigned to experimental (n = 25) and waiting-list control group (n=28) by stratified randomization. All participants received an illustrated psychoeducation booklet. The intervention group received six bio-weekly support group sessions, and the control group will receive the same support group sessions after the posttest. Participants in both groups received baseline and post-test assessments. The caregivers were assessed with the Chinese versions of Self-Efficacy for Managing Chronic Disease 6-item Scale, Self-Efficacy Questionnaire for Chinese Family Caregivers and Self-Management Behaviors Scale. The care recipients were measured with the Chinese version of Disability Assessment in Dementia.Preliminary results of the ongoing study:A significant interaction between time and group was found in total scores of self-efficacy for managing chronic disease and caregiving self-efficacy for gathering information (P<0.05). After intervention, caregivers in experimental group reported significant improvements in the total scores of self-efficacy for managing chronic disease, caregiving self-efficacy, and three self-management behaviors (stretching and strengthening exercise, cognitive symptom management, and communication with physicians). The care recipients’ levels of activities of daily living in each group were worse at posttest compared to those at baseline (P<0.01).Conclusion:The findings indicated that the CD-SMS program was effective in improving the caregivers’ confidence in balancing their caregiving management and their chronic health conditions management, and their main health behaviors were also improved.


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