The chronic disease Self‐Management Programme: A phenomenological study for empowering vulnerable patients with chronic diseases included in the EFFICHRONIC project

Abstract

Introduction:The Chronic Disease Self-Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles.Aim: This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation.Methods: We conducted a qualitative phenomenological semio-pragmatic study based on 37 in-depth interviews with 20 patients (20 before/17 after CDSMP).Results: By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person.By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education. Conclusion:Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient-centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient.

Impact of Chronic Disease Self-Management Program on the Self-Perceived Health of People in Areas of Social Vulnerability in Asturias, Spain

“…Among the various results evaluated in EFFICHRONIC, improvements have been reported in Self-perceived frailty [38], desires for lifestyle improvements, and a sense of community belonging [39], among others. In Spanish participants, six months after entering the program, 22.9% showed an improvement in SPH, and 38.9% remained well.…”

Self-efficacy as a mediator between frailty and falls among community-dwelling older citizens

“…An example of a program that considers the variable of self-efficacy and its importance in the promotion of health is the Chronic Disease Self-Management Program (CDSMP), developed at Stanford University and based on Bandura's socio-cognitive theories of self-efficacy and self-regulation (Bandura, 1977(Bandura, , 1991. It consists in workshops for adults with at least one chronic disease to improve their disease management skills, increasing motivation and well-being and enhancing self-efficacy substantially, concurring to lower healthcare utilization (Fracso et al, 2022;Hevey et al, 2020;Zora et al, 2021).…”

Cancer pain management program: Patients' experiences–A qualitative study

“…The main elements that contributed to the strong relationship between patients and their healthcare professionals were the patients' feeling that they were the center of care, trust, satisfaction, and gaining knowledge. The importance of a constructive patient−healthcare professional relationship appears to lie in its influence on patient behaviors, improvement of self‐efficacy, and self‐management of pain 32 . The codes under the major theme “healthcare professionals' relationship” highlighted the importance of this relationship and its role in motivating patients to maintain pain control and initiating a sense of self‐management of their pain.…”

“…The importance of a constructive patient−healthcare professional relationship appears to lie in its influence on patient behaviors, improvement of self-efficacy, and self-management of pain. 32 The codes under the major theme "healthcare professionals'…”