The Perspectives of Patients with Chronic Diseases and Their Caregivers on Self-Management Interventions: A Scoping Review of Reviews.


Journal

The patient
ISSN: 1178-1661
Titre abrégé: Patient
Pays: New Zealand
ID NLM: 101309314

Informations de publication

Date de publication:
11 2021
Historique:
accepted: 26 03 2021
pubmed: 20 4 2021
medline: 8 1 2022
entrez: 19 4 2021
Statut: ppublish

Résumé

Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives. We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions. We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions. The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decision-making processes, including the formulation of recommendations, and the design and implementation of SM interventions.

Sections du résumé

BACKGROUND
Self-management (SM) interventions are supportive interventions systematically provided by healthcare professionals, peers, or laypersons to increase the skills and confidence of patients in their ability to manage chronic diseases. We had two objectives: (1) to summarise the preferences and experiences of patients and their caregivers (informal caregivers and healthcare professionals) with SM in four chronic diseases and (2) to identify and describe the relevant outcomes for SM interventions from these perspectives.
METHODS
We conducted a mixed-methods scoping review of reviews. We searched three databases until December 2020 for quantitative, qualitative, or mixed-methods reviews exploring patients' and caregivers' preferences or experiences with SM in type 2 diabetes mellitus (T2DM), obesity, chronic obstructive pulmonary disease (COPD), and heart failure (HF). Quantitative data were narratively synthesised, and qualitative data followed a three-step descriptive thematic synthesis. Identified themes were categorised into outcomes or modifiable factors of SM interventions.
RESULTS
We included 148 reviews covering T2DM (n = 53 [35.8%]), obesity (n = 20 [13.5%]), COPD (n = 32 [21.6%]), HF (n = 38 [25.7%]), and those with more than one disease (n = 5 [3.4%]). We identified 12 main themes. Eight described the process of SM (disease progression, SM behaviours, social support, interaction with healthcare professionals, access to healthcare, costs for patients, culturally defined roles and perceptions, and health knowledge), and four described their experiences with SM interventions (the perceived benefit of the intervention, individualised care, sense of community with peers, and usability of equipment). Most themes and subthemes were categorised as outcomes of SM interventions.
CONCLUSION
The process of SM shaped the perspectives of patients and their caregivers on SM interventions. Their perspectives were influenced by the perceived benefit of the intervention, the sense of community with peers, the intervention's usability, and the level of individualised care. Our findings can inform the selection of patient-important outcomes, decision-making processes, including the formulation of recommendations, and the design and implementation of SM interventions.

Identifiants

pubmed: 33871808
doi: 10.1007/s40271-021-00514-2
pii: 10.1007/s40271-021-00514-2
pmc: PMC8563562
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

719-740

Informations de copyright

© 2021. The Author(s).

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Auteurs

Ena Niño de Guzmán Quispe (E)

Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain. ENino@santpau.cat.

Laura Martínez García (L)

Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain.
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Carola Orrego Villagrán (C)

Avedis Donabedian Research Institute (FAD), Barcelona, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
Universitat Autònoma de Barcelona, Barcelona, Spain.

Monique Heijmans (M)

Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.

Rosa Sunol (R)

Avedis Donabedian Research Institute (FAD), Barcelona, Spain.
Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
Universitat Autònoma de Barcelona, Barcelona, Spain.

David Fraile-Navarro (D)

Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Madrid Primary Health Care Service, Madrid, Spain.

Javier Pérez-Bracchiglione (J)

Interdisciplinary Centre for Health Studies (CIESAL), Universidad de Valparaíso, Valparaíso, Chile.

Lyudmil Ninov (L)

European Patients' Forum, Brussels, Belgium.

Karla Salas-Gama (K)

Health Services Research Group, Institut de Recerca Vall d'Hebron Hospital, Barcelona, Spain.
Vall d'Hebron University Hospital, Barcelona, Spain.

Andrés Viteri García (A)

Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC), Universidad UTE, Quito, Ecuador.
Centro Asociado Cochrane de Ecuador, Universidad UTE, Quito, Ecuador.

Pablo Alonso-Coello (P)

Iberoamerican Cochrane Centre (IbCC)-Sant Pau Biomedical Research Institute (IIB-Sant Pau), C/ Sant Antoni Maria Claret 167. Pabellón 18, Planta 0, 08025, Barcelona, Spain.
CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

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