Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes

Abstract

The Sharing Health Care SA chronic disease selfmanagement (CDSM) project in rural South Australia was designed to assist patients with chronic and complex conditions (diabetes, cardiovascular disease and arthritis) to learn how to participate more effectively in the management of their condition and to improve their self-management skills. Participants with chronic and complex conditions were recruited into the Sharing Health Care SA program and offered a range of education and support options (including a 6-week peer-led chronic disease self-management program) as part of the Enhanced Primary Care care planning process. Patient self-reported data were collected at baseline and subsequent 6-month intervals using the Partners in Health (PIH) scale to assess selfmanagement skill and ability for 175 patients across four data collection points. Health providers also scored patient knowledge and self-management skills using the same scale over the same intervals. Patients also completed a modified Stanford 2000 Health Survey for the same time intervals to assess service utilisation and health-related lifestyle factors.Results show that both mean patient self-reported PIH scores and mean health provider PIH scores for patients improved significantly over time, indicating that patients demonstrated improved understanding of their condition and improved their ability to manage and deal with their symptoms. These results suggest that involvement in peer-led selfmanagement education programs has a positive effect on patient self-management skill, confidence and health-related behaviour.

The internal consistency and construct validity of the partners in health scale: validation of a patient rated chronic condition self-management measure

“…Lincoln [7] South Australia, was based on the initial work of the Eyre Peninsula coordinated care trials [4,[8][9][10] and a chronic illness management pilot programme conducted in rural Aboriginal communities in Port Lincoln and Ceduna [11].…”

“…The data set of 118 separate subjects from the same chronic condition self-management demonstration programme [7] was used as the validation sample and the saved structural equation model was applied to this new data (Fig 2b).…”

Chemotherapy and patient co-morbidity in ventral site hernia development

“…5,25 In high risk patients, relevant management in the form of nutritional evaluation, diabetes or cardiovascular education, and routine medical follow-up are essential to assure favorable surgical and medical outcomes. 26 However, since the incidence of hernias in this group of patients is rather low, a cost analysis to investigate the value of preventive surgical intervention during gynecologic cancer surgery may be warranted. We recognize that serum albumin levels would have been an interesting variable to consider, particularly given that this protein has been studied extensively as an indirect measure of nutrition and appears to be associated with inferior outcomes in ovarian cancer surgery.…”

Validation study of a Chinese version of Partners in Health in Hong Kong (C-PIH HK)

“…Factor analysis supported a 3-factor solution (Cronbach's alpha = 0.88) [3]. Later, two 12-item versions were developed (version A and version B 1 ) [4,5] and demonstrated good construct validity and internal consistency in the English, Spanish, and Dutch versions (Cronbach's alphas ranged from 0.66 to 0.82) [4,6,7]. The PIH has been used to validate the Multiple Sclerosis Self-Management Scale [8].…”