Box 3.
Themesa
| Study | Somatic symptoms and physical functioning | Psychological symptoms | Self-efficacy | Self-care | Quality of life | Knowledge of illness or health |
|---|---|---|---|---|---|---|
| Berg,14 1997 | – Journal of daily asthma concerns including wheeze, cough, shortness of breath, and chest tightness | – | – (SEAMS)a |
+ Post-treatment inhaler use (observed) – (ASMAT) Ability to make good decisions in a variety of clinical scenarios, for example, severe asthma attack |
– | – |
| Coleman,15 2012 |
+ Pain: WOMAC at 8 weeks, not maintained at 6 months + SF-36 body pain maintained at 6 months + (TUG) Hamstring strength and range of motion test (small improvements) maintained at 6 months |
– | – | – |
+ (WOMAC — physical functioning and total scores: SF-36 physical function, physical role, vitality, and social function) At 8 weeks, maintained at 6 months |
– |
| Elzen,16 2007 | – (RAND-36, physical component summary scale of the Dutch version) | – (RAND-36, mental component summary scale of the Dutch version) | – (GSES — Dutch version) | – Self-management behaviour using scales developed by Lorig for the CDSMP,29 frequency of exercise, cognitive symptom-management (coping with symptoms scale), and (quality of) communication with a physician (self-reported scale) | – | – |
| Grady,25 2014 | – (SF-36 — physical functioning scores) | – | – | – | – (QLI) | – |
| Henry,27 1997 | – |
+ (STAI) Anxiety and perceived stress (Hassles scale) – (BDI) Depression – Coping ability, frequency of hassles, and perceived coping ability (Hassles scale) |
– | – | – | – |
| Jonker,17 2015 | – |
+ (CES-D) Depression scores at 6 months – Positive affect (CES-D assessed separately using a specific subscale of the CES-D) |
+ (12-item version of the perceived self-efficacy scale) + (Abbreviated version of the Pearlin Mastery scale). People with less education (≤9 years) benefited more. Those with >9 years of education showed no significant effect |
– | + (Dutch version of VOL-scale) At 6 weeks and 6 months | – |
| Kendall,18 2007 | – | – | – (Lorig SES) | – |
+ (SSQoL – which includes domains measuring physical, psychological, and social wellbeing). At 9 months for family roles and fine motor tasks + A trend towards significance (P = 0.05) in relation to work productivity and self-care – Physical, psychological, and social domains of the SSQoL |
– |
| Leibing,22 1999 |
– Disease activity + (VAS) Pain at 9 months’ follow-up + Affective pain score |
+ (STAI, DS, AHI) + Anxiety, depression, and helplessness + Coping (adapted BeCoMo), positive acceptance, and resignation |
– | – | – | – |
| Lindroth,19 1997 | + (VAS) Pain at 3 months, not maintained at 12 months | – (Single question) |
– (Swedish version of the AHI) Perceived helplessness did not change + (Single question) Self-confidence at 3 and 12 months |
+ (Interview) Joint protection behaviours at 3 and 12 months and more home exercises at 3 months + (Single question) Capacity to ease pain at 3 and 12 months |
+ (Swedish version of the Stanford HAQ). Perceived disability at 3 months, not maintained at 12 months |
+ (Assessed on five key questions with yes or no answer options). At 3 and 12 months + Change in knowledge about inflammation and different arthritis treatments correlated positively with a reduction in helplessness. The intervention group reported fewer problems due to lack of knowledge about disease, diet, and physical therapy at 3 and 12 months |
| Ruesch,28 2017 | – |
+ (Depression subscale of the German version of HADS) immediately post-intervention but not maintained – Global psychological distress (German version of the BSI — Global Severity Index calculated the means of all items) |
– | – |
+ Health-related quality of life (German version of SF-12): on mental composite scores immediately post-intervention but not maintained at 2 months + On physical composite scores treatment group significantly improved post-treatment and at 2 month’s follow-up |
– |
| Rybarczyk,23 1999 |
– (MSCL) In frequency of medical symptoms + (SF-MPQ and MSCL sleep, pain) |
+ (BAI, CES-D) Significant decrease in anxiety and depression symptoms + Those defined as having clinical levels of anxiety – Those defined as having clinical depression |
+ (MHLC) Belief that chance factors influence health – Internality, powerful others |
– Health behaviours | – | – |
| Scott,26 2004 | – (Advanced, household, and basic ADLs Functional outcomes: a composite measure derived from two established tools) | – |
+ (Scales drawn from Lorig29) Communicating with physicians – Managing their disease, doing chores, participating in social/recreational activities, and controlling/managing depression (scales drawn from Lorig29) |
– | + (QOL score) 10-point self-reported quality-of-life scale at 24 months | – |
| Smeulders,20 2010 | – | – (HADS) |
+ Psychosocial attributes (GSES — Dutch version: Cardiac Self-Efficacy Questionnaire). (Pearlin Mastery scale) Perceived control + (Coping With Symptoms Scale — Lorig) Cognitive symptom management not maintained at 6 and 12 months’ follow-up |
+ (EHFScBS) Self-care, short-term effect not maintained at 6 and 12 months | + (RAND-36, KCCQ, Perceived autonomy VAS and HADS) short-term effect not maintained at 6 months | – |
| Zangi,24 2012 |
+ (Numerical Rating Scales) Fatigue post-treatment that improved at 12 months – Effects in pain and the patient global assessment of disease activity |
+ (GHQ-20, EAC) Psychological distress at 12 months in the intervention groupb + Emotional processing – Emotional expression |
+ (Pain and symptoms subscales from the Arthritis SES) Self-efficacy pain indicating better ability to manage pain despite the lack of significant improvement in symptoms – Self-efficacy – general, cardiac, symptom management |
+ (10-point NRS) Self-care ability and overall wellbeing maintained at 12 months | – | – |
Assessment tool used by study is shown in brackets.
Number of participants exceeding the GHQ-20 threshold of 23 (indicating significant psychological distress) was reduced from 13 (36%) at baseline to 2 (6%) at 12 months compared with 10 (29%) at baseline to 8 (24%) at 12 months in the control group. + = statistically significant outcome – = no statistically significant outcome. ADL = Activities of Daily Living. AHI = Arthritis Helplessness Index. Arthritis SES = Arthritis Self-Efficacy Scale. ASMAT = Asthma Self-Management Assessment Tool. BAI = Beck Anxiety Inventory. BDI = Beck Depression Inventory. BeCoMo = Bernese Coping Modes Tool. BSI = Brief Symptom Inventory (German version). CDSMP = Chronic Disease Self-management Programme. CES-D = Centre for Epidemiologic Studies Depression Scale. DS = Depression Scale. EAC = Emotional Approach to Coping Scale. EHFScBS = European Heart Failure Self-Care Behaviour Scale. GHQ-20 = General Health Questionnaire. GSES = General Self-Efficacy Scale. HADS = Hospital Anxiety and Depression Scale. HAQ = Stanford Health Assessment Questionnaire (Swedish version). KCCQ = Kansas City Cardiomyopathy Questionnaire. MHLC = Multidimensional Heath Locus of Control Scale. MSCL = Medical Symptoms Checklist. NRS = numerical rating scale. QLI = Quality of Life Index (cardiac version). QOL = quality of life. RAND-36 = RAND. SEAMS = Self-Efficacy for Asthma Management Scale. SES = self-efficacy scale. SF-12 = Short Form (12 item) Health Survey (German version). SF-36 = Short Form (36 item) Health Survey. SF-MPQ = Short-form McGill Pain Questionnaire. SSQoL = Stroke Specific Quality of Life Scale. STAI = Spielberger State-Trait anxiety scale. TUG = Timed ‘Up and Go’ test. VAS = Visual Analogue Scale. VOL-scale = Value of Life scale. WOMAC = Western Ontario and McMaster Universities Osteoarthritis Index.