scholarly journals What impact do chronic disease self-management support interventions have on health inequity gaps related to socioeconomic status: a systematic review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ruth Hardman ◽  
Stephen Begg ◽  
Evelien Spelten
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Chronic Disease ◽  
Health Inequity ◽  
Self Management ◽  
Management Support

scholarly journals What impact do chronic disease self-management support interventions have on health inequity gaps related to socioeconomic status: A Systematic Review

2019 ◽  
Author(s):  
Ruth Hardman ◽  
Evelien Spelten ◽  
Stephen Begg
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Chronic Disease ◽  
Health Inequity ◽  
Self Management ◽  
Low Ses ◽  
Management Support ◽  
Post Intervention ◽  
Patient Capacity ◽  
The Social

Abstract Background: The social gradient in chronic disease (CD) is well-documented, and the ability to effectively self-manage is crucial to reducing morbidity and mortality from CD. This systematic review aimed to assess the moderating effect of socioeconomic status on self-management support (SMS) interventions in relation to participation, retention and post-intervention outcomes. Methods: Six databases were searched for studies of any design published until December 2018. Eligible studies reported on outcomes from SMS interventions for adults with chronic disease living in industrialised countries, where socioeconomic status was recorded and a between-groups comparison on SES was made. Possible outcomes were participation rates, retention rates and clinical or behavioural post-intervention results. Results: Nineteen studies were retrieved, including five studies on participation, five on attrition and nine studies reporting on outcomes following SMS intervention. All participation studies reported reduced engagement in low SES cohorts. Studies assessing retention and post-intervention outcomes had variable results, related to the diversity of interventions. A reduction in health disparity was seen in longer interventions that were individually tailored. Most studies did not provide a theoretical justification for the intervention being investigated, although four studies referred to Bandura’s concept of self-efficacy. Conclusions: The limited research suggests that socioeconomic status does moderate the efficacy of SMS interventions, such that without careful tailoring and direct targeting of barriers to self-management, SMS may exacerbate the social gradient in chronic disease outcomes. Screening for patient disadvantage or workload, rather than simply recording SES, may increase the chances of tailored interventions being directed to those most likely to benefit from them. Future interventions for low SES populations should consider focussing more on treatment burden and patient capacity. Trial registration: PROSPERO registration CRD42019124760 Keywords: Self-management, socioeconomic status, health inequity, patient capacity, chronic disease

scholarly journals What impact do chronic disease self-management support interventions have on health inequity gaps related to socioeconomic status: A Systematic Review

2020 ◽  
Author(s):  
Ruth Hardman ◽  
Stephen Begg ◽  
Evelien Spelten
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Chronic Disease ◽  
Health Inequity ◽  
Social Gradient ◽  
Self Management ◽  
Low Ses ◽  
Management Support ◽  
Post Intervention ◽  
Patient Capacity

Abstract Background:The social gradient in chronic disease (CD) is well-documented, and the ability to effectively self-manage is crucial to reducing morbidity and mortality from CD. This systematic review aimed to assess the moderating effect of socioeconomic status on self-management support (SMS) interventions in relation to participation, retention and post-intervention outcomes. Methods:Six databases were searched for studies of any design published until December 2018. Eligible studies reported on outcomes from SMS interventions for adults with chronic disease, where socioeconomic status was recorded and a between-groups comparison on SES was made. Possible outcomes were participation rates, retention rates and clinical or behavioural post-intervention results. Results: Nineteen studies were retrieved, including five studies on participation, five on attrition and nine studies reporting on outcomes following SMS intervention. All participation studies reported reduced engagement in low SES cohorts. Studies assessing retention and post-intervention outcomes had variable results, related to the diversity of interventions. A reduction in health disparity was seen in longer interventions that were individually tailored. Most studies did not provide a theoretical justification for the intervention being investigated, although four studies referred to Bandura’s concept of self-efficacy. Conclusions:The limited research suggests that socioeconomic status does moderate the efficacy of SMS interventions, such that without careful tailoring and direct targeting of barriers to self-management, SMS may exacerbate the social gradient in chronic disease outcomes. Screening for patient disadvantage or workload, rather than simply recording SES, may increase the chances of tailored interventions being directed to those most likely to benefit from them. Future interventions for low SES populations should consider focussing more on treatment burden and patient capacity. Trial registration:PROSPERO registration CRD42019124760. Registration date 17/4/19. Keywords: Self-management, socioeconomic status, health inequity, patient capacity, chronic disease

scholarly journals What impact do chronic disease self-management support interventions have on health inequity gaps related to socioeconomic status: A Systematic Review

2019 ◽  
Author(s):  
Ruth Hardman ◽  
Stephen Begg ◽  
Evelien Spelten
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Chronic Disease ◽  
Health Inequity ◽  
Self Management ◽  
Low Ses ◽  
Management Support ◽  
Post Intervention ◽  
Patient Capacity ◽  
The Social

Abstract Background: The social gradient in chronic disease (CD) is well-documented, and the ability to effectively self-manage is crucial to reducing morbidity and mortality from CD. This systematic review aimed to assess the moderating effect of socioeconomic status on self-management support (SMS) interventions in relation to participation, retention and post-intervention outcomes. Methods: Six databases were searched for studies of any design published until December 2018. Eligible studies reported on outcomes from SMS interventions for adults with chronic disease, where socioeconomic status was recorded and a between-groups comparison on SES was made. Possible outcomes were participation rates, retention rates and clinical or behavioural post-intervention results. Results: Nineteen studies were retrieved, including five studies on participation, five on attrition and nine studies reporting on outcomes following SMS intervention. All participation studies reported reduced engagement in low SES cohorts. Studies assessing retention and post-intervention outcomes had variable results, related to the diversity of interventions. A reduction in health disparity was seen in longer interventions that were individually tailored. Most studies did not provide a theoretical justification for the intervention being investigated, although four studies referred to Bandura’s concept of self-efficacy. Conclusions: The limited research suggests that socioeconomic status does moderate the efficacy of SMS interventions, such that without careful tailoring and direct targeting of barriers to self-management, SMS may exacerbate the social gradient in chronic disease outcomes. Screening for patient disadvantage or workload, rather than simply recording SES, may increase the chances of tailored interventions being directed to those most likely to benefit from them. Future interventions for low SES populations should consider focussing more on treatment burden and patient capacity. Trial registration: PROSPERO registration CRD42019124760 Keywords: Self-management, socioeconomic status, health inequity, patient capacity, chronic disease

scholarly journals Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

2013 ◽  
Vol 15 (2) ◽  
pp. e35 ◽  
Author(s):  
Michael Stellefson ◽  
Beth Chaney ◽  
Adam E Barry ◽  
Enmanuel Chavarria ◽  
Bethany Tennant ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Chronic Disease ◽  
Web 2.0 ◽  
Self Management

The effectiveness of interventions to enhance self-management support competencies in the nursing profession: a systematic review

2017 ◽  
Vol 73 (8) ◽  
pp. 1807-1824 ◽  
Author(s):  
Veerle Duprez ◽  
Tina Vandecasteele ◽  
Sofie Verhaeghe ◽  
Dimitri Beeckman ◽  
Ann Van Hecke
Keyword(s):  
Systematic Review ◽  
Nursing Profession ◽  
Self Management ◽  
Management Support

Depression self-management support: A systematic review

2013 ◽  
Vol 91 (3) ◽  
pp. 271-279 ◽  
Author(s):  
Janie Houle ◽  
Marjolaine Gascon-Depatie ◽  
Gabrielle Bélanger-Dumontier ◽  
Charles Cardinal
Keyword(s):  
Systematic Review ◽  
Self Management ◽  
Management Support

scholarly journals Self-management of patients with advanced cancer: A systematic review of experiences and attitudes

2020 ◽  
Vol 34 (2) ◽  
pp. 160-178 ◽  
Author(s):  
Sophie I van Dongen ◽  
Kim de Nooijer ◽  
Jane M Cramm ◽  
Anneke L Francke ◽  
Wendy H Oldenmenger ◽  
...  
Keyword(s):  
Systematic Review ◽  
Advanced Cancer ◽  
Healthcare Professionals ◽  
Management Strategies ◽  
Personal Characteristics ◽  
Qualitative Studies ◽  
Medical Decision ◽  
Self Management ◽  
Management Support ◽  
Quality Of Reporting

Background: Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. Aim: To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. Design: A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. Data sources: MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). Results: Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient–professional partnerships (three articles). Conclusion: Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.

scholarly journals Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis

2017 ◽  
Vol 14 (2) ◽  
pp. 79-103 ◽  
Author(s):  
Marika Franklin ◽  
Sophie Lewis ◽  
Karen Willis ◽  
Helen Bourke-Taylor ◽  
Lorraine Smith
Keyword(s):  
Systematic Review ◽  
Healthcare Professionals ◽  
Care Delivery ◽  
Individual Responsibility ◽  
Self Management ◽  
Chronic Obstructive ◽  
Traditional Model ◽  
Management Support ◽  
Model Of Care ◽  
Qualitative Synthesis

Objective To review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions. Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004–2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient–provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria. Results Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients’ responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes ‘effective’ self-management. Discussion Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.

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