Improving Self-Efficacy in Chronically-Ill individuals: A First Look at the Effectiveness of a Chronic Disease Self-Management Program in Southeast Missouri Open Access

Abstract

Self-management programs enhance self-efficacy in the adoption and sustenance of healthier behaviors among chronically-ill individuals. They provides the opportunity for patients to play an active role in managing their conditions, ultimately promoting coping-independence and better health outcomes. The purpose of this study was to examine the effectiveness of the Chronic Disease Self-Management Program (CDSMP) in improving perceived self-efficacy in self-management behaviors among a random sample of individuals who live with chronic diseases in Southeast Missouri. Secondary data analysis was conducted on 46 adult participants. Data were collected at Week 1 (baseline) and Week 6 (post-CDSMP). A dependent t test was conducted to examine outcome measurements related to perceived self-efficacy in seven chronic disease self-management behaviors. The mean age of participants was 55.02 (±14.639) years; the majority was female (67.4%), White (73.9%), and 100% reported at least one chronic disease. A dependent t test analysis indicated the CDSMP was effective in improving perceived self-efficacy in all seven self-management behaviors: Managing condition (p = 0.005, 95% CI = -1.462, -.277), eating healthier (p = 0.002, 95% CI = -1.520, -.349), being physically active (p <.001, 95% CI = -1.690, -.527), managing stress (p <.001, 95% CI = -1.664, -.510), making treatment decisions (p <.001, 95% CI = -2.475, -1.134), taking medications (p <.001, 95% CI = -2.419, -.885), and managing pain (p <.001, 95% CI = -2.290, -.927). A wide-scale integration of the CDSMP into the routine care, health organizations’ standards of care, case management, and referrals hold promise for better disease control and improved health outcomes among chronically-ill individuals.

Table of Contents

Chapter I: Introduction. 1

Introduction and Rationale. 1

The Chronic Disease Self-Management Program.. 2

Problem Statement 3

Theoretical Framework. 4

Purpose Statement 5

Research Questions and Hypotheses. 6

Research Questions (RQ) 6

Hypotheses. 6

Significance. 8

Definition of Terms. 9

Chapter II: Review of the Literature. 11

Introduction. 11

Literature Review Strategy. 11

Review of Literature Related to Chronic Disease Self-Management 12

Review of Literature related to the Stanford Model of the CDSMP. 13

Review of Literature Related to Theoretical Framework: Self-Efficacy Theory. 15

Review of Literature Related to Healthcare Savings. 16

Chapter III: Methodology. 19

Introduction. 19

Purpose of Study. 19

Objectives of the Study. 19

Sample Characteristics. 20

Research Design and Methodology. 21

Data Collection Procedures. 21

Operationalization and Measurements of Variables. 23

Instrumentation. 23

Data Analysis. 24

Chapter IV: Results. 25

Introduction. 25

Key Findings. 25

Correlations. 26

Summary. 37

Chapter V: Conclusions, Implications, and Recommendations. 38

Introduction. 38

Summary of Study. 38

Limitations. 39

Implications. 40

Recommendations. 41

Conclusion. 42

References. 44

Appendix A.. 56

List of Tables

Table 1. G*Power Statistical Power Computation for Sample Size.................................. 21

Table 2. Dependent t-Test Table Suggesting Changes in Perceived Self-Efficacy in all Seven Areas Pre- and Post CDSMP; N = 46....27

Table 3. Dependent t-Test Table Suggesting Changes in Perceived Self-Efficacy in all Seven Areas Pre- and Post CDSMP; N = 46..... 36

List of Figures  

Figure 1. Concept of influences on perceived self-efficacy based on the conceptions of Bandura  5

Figure 2. Mean changes in perceived self-efficacy in managing condition pre- and post CDSMP, p = 0.005         28

Figure 3. Mean changes in perceived self-efficacy in eating healthier pre- and post CDSMP, p = 0.002    29

Figure 4. Mean changes in perceived self-efficacy in being physically active pre- and post CDSMP, p < 0.001    30

Figure 5. Mean changes in perceived self-efficacy in managing stress pre- and post CDSMP, p < 0.001   31

Figure 6. Mean changes in perceived self-efficacy in making treatment decisions pre- and post CDSMP, p < 0.001. 32

Figure 7. Mean changes in perceived self-efficacy in taking medications pre- and post CDSMP, p < 0.001          33

Figure 8. Mean changes in perceived self-efficacy in managing pain pre- and post CDSMP, p < 0.001     34

Figure 9. Comparison of pre-and post-CDSMP time points for all seven areas................ 35 

About this Master's Thesis

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School	Rollins School of Public Health
Department	Executive Masters of Public Health - MPH
Subfield / Discipline	Prevention Science
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Public Health Education
Keyword	Chronic Diseases CDSMP Self-Management Self-Efficacy
Committee Chair / Thesis Advisor	Smith, Iris, Emory University
Committee Members	Commodore-Mensah, Yvonne,
Partnering Agencies	Hospital or other health care provider

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