Citation

Purpose

Theoretical

Framework

Setting

Design

Sample

Outcomes Measurement

Results/Findings

Author Interpretation/ Limitations

LOE

Ory, M., et al. (2013)

Purpose:

Evaluate the effect of the CDSMP on health outcomes, lifestyle behaviors, and healthcare utilization

Self-efficacy

Multiple community sites in 17 states.

U.S.

・ Pre-post Design

Role modeling with peer led groups.

・ 6-month follow-up.

・ N = 1170

・ Mean age 65

・ Female = 83%

・ White = 55%

・ Education Mean 12 years

・ Heterogeneous Disease Sample

・ Social/Role Limitations

・ Depression

・ Communication with physicians

・ Health related behaviors

Findings:

Significant improvement in outcomes at 6 months

Conclusions:

・ Confirms improved outcomes in older adults

・ Improved quality of life

Limitations:

・ No control group

・ Greater variability in community based programs

・ Self-report of variables

2b

Park, Y.H. et al. (2012)

Purpose: Evaluate the effects of an individualized self-management intervention for nursing home patients with hypertension

None

Nursing Home

Korea

・ Non-equivalent comparison group

・ 8 week post intervention evaluation

・ Provider Led education

Sample:

・ N = 47

・ Mean Age 77

・ 72% Female

・ 93% 12^th grade or less

・ Diagnosed with hypertension

・ Blood Pressure and self-care behaviors

Findings:

Intervention group was found to have lower blood pressure and increased activity. No difference in medication adherence.

Conclusions:

Effective intervention, but need further studies to validate.

Limitations:

・ Small sample size,

・ Convenience sample

2b

Chan et al. (2011)

Evaluate the effectiveness of the Chronic Disease Self-Management Program (CDSMP) adapted in Hong Kong

None stated

Community based organizations

samples in groups per locality

Hong Kong

・ Longitudinal, Quasi-experimental

・ 6 weekly sessions

・ 6 month follow-up

・ Adapted program by trained professional or lay leader

・ 6 month follow-up

・ N = 302 Intervention

・ N = 298 control

・ Mean Age:

・ Intervention:

73 years 77% female

・ Control:

76 years 83% Female

・ Education: 4 years both groups

・ Heterogeneous Disease population

・ Demographics; self-management behaviors; self-efficacy; health status; healthcare utilization (validity and reliability not stated)

・ Interventional group showed significant increase in self-efficacy (p < 0.005) with control group deteriorating from baseline

・ Health Status:

・ activity limitations decreased (p < 0.004)

・ depressive symptoms (p < 0.001)

・ health distress decrease (p < 0.014)

・ Pain and discomfort decrease (p = 0.006)

・ -No difference in healthcare utilization

Interpretation:

・ At 6 months there were improvements in self-management behaviors, self-efficacy, and health outcomes in treatment group.

Reported Limitations:

・ Random sampling not utilized, volunteers might have improved motivation to participate, need longer follow-up, baseline data adjusted for group differences could affect ability to detect changes

Generalizability: to locality, volunteers could limit generalizability

2b

Kao et al. (2011)

Evaluate effectiveness of self-management program in patients with knee osteoarthritis (TOAP program)

Self-Efficacy Theory and Social Learning Theory

Taiwan:

4 districts in Taipei

2 districts assigned to intervention and then divided into smaller groups for program delivery

2 districts assigned to control

・ Quasi-experimental

・ Routine Care versus TOAP intervention

・ Measurement baseline, immediately post-intervention, and 8 weeks

・ N = 205

・ CG = 91

・ IG = 114

・ Mean Age = 67

・ 80.7% Female

・ 47% with elementary or less education

・ 30% High School Education

・ Diagnosed with arthritis

・ Demographics; Health Related Quality of Life (SF-36); Disability- TWOMAC- reliability and validity of both previously established

・ No statistical difference in disability measures from baseline to 8 weeks.

・ SF-36 subscale in general health and emotional status showed improvement in control group but was not statistically significant

Interpretation:

・ The increase in mental scores (MCS) on the SF-36 could indicate increased psychology benefits as lower MCS has been linked to depression, unhappiness, etc. that has been demonstrated in other studies.

・ Physical benefits are linked to increased exercise protocols.

・ There was not a significant change in the IG in disability or pain supporting that self-management provides psychology benefits.

Limitations:

・ Cluster randomization could decrease participation and limit data to the immediate population.

・ Self-report instruments creating possible response bias.

Generalizability: Cannot be generalized due to lower education percentage, volunteers could limit generalizability

2b