Evaluation on Shanghai chronic disease self-management program

  Objective   To evaluate the six-month effectiveness of Shanghai Chronic Disease Self-Management Program.

  Methods   The study was a community-based randomized controlled trial.954 volunteer participants with hypertension, heart disease, arthritis, stroke, asthma, diabetes, and COPD, were randomized to treatment group or control group.Analysis of covariance based on Rank Scores(Cochran-Mantel-Haenszel Statistics)was used to compare six-month changes of 20 outcome variables(Self-Management Behaviors, Self-Efficacy(SE), Health Status and Health Service Utilization)for 430 treatment subjects and 349 control subjects who complete 6-month study.

  Results   Treatment subjects, compared with controls were demonstrated significant improvement in one of four self-management behaviors(treatment subjects averagely increased 0.33 more scores in practice of cognitive symptom management).Treatment group increased 0.69 and 0.63 scores separately in SE to manage symptom and SE to manage disease in general.They also demonstrated significant improvement in nine of health status(self-rated health, health distress, fatigue, shortness of breath, pain, disability, illness intrusiveness, depression and social/role activities limitation)(allP < 0.05).They also had fewer visits of 0.01 frequency to emergency room on average(P=0.02), fewer hospitalization of(P=0.01).

  Conclusion   Shanghai Chronic Disease Self-Management Program improved participants'health behavior, self-efficacy, parts of health status, fewer visits to emergency room and hospitalization after 6-month implementation.