| Methods |
A 6‐month randomised controlled trial at community based sites comparing treatment patients with waiting list control patients. Control patients received the programme after 6 months.
Assessments were done at baseline and after 6 months.
Quality: 0/0/2/2 |
| Participants |
1,140 patients responding to public service announcements in the mass media, referrals from flyers left in physician's offices and community clinics, posters at senior citizen centres, announcements in health maintenance organisation (HMO) patient newsletters, and referrals from county government employers were recruited and randomised (I: 664; C: 476). 952 (83%) completed the 6‐month study and were analysed (I: 561; C: 391). Arthritis patients: 521 (I: 314; C: 207).
Inclusion: patients 40 years of age or older with a physician‐confirmed diagnosis of heart disease, lung disease, stroke or arthritis.
Patients with compromised mentation, and cancer patients who received chemotherapy or radiation within the past year were excluded.
Mean age: 65.4yr, range: 40‐90yr, 65% female. |
| Interventions |
Intervention: The Chronic Disease Self‐management Program (CDSMP) is a community‐based patient self‐management education course. Sessions are led by two trained lay persons with chronic conditions. The programme was given in 7 weekly 2.5h sessions. Topics included: exercise; use of cognitive symptom management techniques; nutrition; fatigue and sleep management; use of community resources; use of medications; dealing with the emotions of fear, anger and depression; communication with others including health professionals; problem‐solving; and decision‐making. The book: "Living a Healthy Life with Chronic Conditions" was used as a text for participants and details the content of the course. The process of teaching is based on Self‐Efficacy Theory. Strategies include: weekly action planning, and feedback, modelling of behaviours and problem‐solving by participants for one another, reinterpretation of symptoms by giving many possible causes for each symptom as well as several different management techniques, group problem‐solving, and individual decision‐making. Each course had 10‐15 participants of mixed ages and diagnoses, including family members if they wished to attend. Controls: waiting list control group. |
| Outcomes |
Included: none.
Not reported: the pain and discomfort scale (an adaption of the Medical Outcomes Study (MOS) pain scale), HAQ, the psychological well‐being scale from the SF‐36 (MHI‐5), and the health distress scale (adapted from the MOS health distress scale).
Others: a self‐rated health scale used in the National Health Interview Survey, the energy/fatigue scale from the MOS, social/role activity limitations, shortness of breath, duration of exercise, use of cognitive symtom management, communication with physicians, visits to physicians, visits to hospitals during the past 6 months, and the number of nights spent in a hospital. |
| Notes |
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