Implementation and Quantitative Evaluation of Chronic Disease Self-Management Programme in Shanghai, China: Randomized Controlled Trial. (Research)

By Dongbo, Fu; Hua, Fu et al. | Bulletin of the World Health Organization, May 2003 | Go to article overview

Implementation and Quantitative Evaluation of Chronic Disease Self-Management Programme in Shanghai, China: Randomized Controlled Trial. (Research)


Dongbo, Fu, Hua, Fu, McGowan, Patrick, Yi-e, Shen, Lizhen, Zhu, Huiqin, Yang, Jianguo, Mao, Shitai, Zhu, Yongming, Ding, Zhihua, Wei, Bulletin of the World Health Organization


Introduction

Chronic diseases--mainly heart disease, stroke, cancer, and lung disease--are becoming leading causes of disability and premature death in China. Noncommunicable diseases accounted for 81% of total deaths in China in 1996 (1). Chronic disease is also a major health care cost for China. In 1994, direct treatment costs related to chronic disease were more than four hundred billion Yuan (2). In China, Shanghai has the heaviest burden of noncommunicable diseases, because it has the largest population and the largest ageing population. Prevention and management of chronic disease is an urgent primary health problem to be addressed in Shanghai. The inability of current major health care systems to deal with chronic conditions calls for prompt policy action and new approaches to people with chronic conditions. Self-management for people with chronic disease is now widely recognized as a necessary part of treatment.

Chronic disease self-management has been shown in the United States, Canada, and the United Kingdom to be useful in maintaining and improving patients' health behaviour and health status, while lowering health care utilization through improved self-management skills, "self-efficacy", and better communication between patients and health providers (3-6). The community-based generic self-management programme developed by Lorig et al. at Stanford University Patient Education Research Center--the Chronic Disease Self-Management Program (CDSMP)--is the most widely accepted self-management patient education programme worldwide, because it is designed to meet the needs of patients who have more than one chronic condition and is taught by trained lay leaders (3). The CDSMP is a community-based patient self-management education course. Several assumptions make this programme suitable for different kinds of patients (7): (1) people with chronic diseases have similar concerns and problems; (2) people with chronic conditions can learn to take responsibility for the day-to-day management of their disease(s) and the physical and emotional problems caused by their disease(s); (3) lay people with chronic conditions, when given a detailed leader's manual, can teach the CDSMP as effectively, if not more effectively, than health professionals; and (4) the process or way the CDSMP is taught is as important, if not more important, than the subject matter taught. The content and process of teaching the CDSMP course are based on self-efficacy theory (8, 9). Self-efficacy refers to people's beliefs in their abilities to perform specific behaviours, which is a key factor to behaviour change and health functioning (9). The courses incorporate strategies suggested by Bandura to enhance self-efficacy (10), including weekly action planning and feedback, modelling of behaviours and problem-solving by participants for one another, reinterpretation of symptoms, several different management techniques, group problem-solving, and individual decision-making. The leaders of the courses act more as facilitators than lecturers. The process is documented in a detailed protocol--the Chronic disease self-management leaders manual (11). Topics covered include: 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 content of the course was published as Living a healthy life with chronic conditions (12), which was used as a textbook for course participants.

To date, no research has tested whether CDSMP would be culturally acceptable for Chinese people and could benefit participants in China, or whether Chinese lay people could be trained to teach CDSMP courses as capably as professionals. This study examined the course's feasibility, benefits, and cultural sensitivity in Shanghai. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Implementation and Quantitative Evaluation of Chronic Disease Self-Management Programme in Shanghai, China: Randomized Controlled Trial. (Research)
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.