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Angwenyi_V_Health_Soc_Care_Community_2020.pdf (704.33 KB)

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2021

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cc by-nc (c) Angwenyi, Vibian et al, 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/183130

An evaluation of self-management outcomes among chronic care patients in community home-based care programmes in rural Malawi: A 12-month follow-up study.

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http://dx.doi.org/ 10.1111/hsc.13094

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"This paper investigates the impact of community home-based care (CHBC) on self-management outcomes for chronically ill patients in rural Malawi. A pre- and post-evaluation survey was administered among 140 chronically ill patients with HIV and non-communicable diseases, newly enrolled in four CHBC programmes. We translated, adapted and administered scales from the Stanford Chronic Disease Self-Management Programme to evaluate patient's self-management outcomes (health status and self-efficacy), at four time points over a 12-month period, between April 2016 and May 2017. The patient's drop-out rate was approximately 8%. Data analysis included descriptive statistics, tests of associations, correlations and pairwise comparison of outcome variables between time points, and multivariate regression analysis to explore factors associated with changes in self-efficacy following CHBC interventions. The results indicate a reduction in patient-reported pain, fatigue and illness intrusiveness, while improvements in general health status and quality of life were not statistically significant. At baseline, the self-efficacy mean was 5.91, which dropped to 5.1 after 12\xC2\xA0months. Factors associated with this change included marital status, education, employment and were condition-related; whereby self-efficacy for non-HIV and multimorbid patients was much lower. The odds for self-efficacy improvement were lower for patients with diagnosed conditions of longer duration. CHBC programme support, regularity of contact and proximal location to other services influenced self-efficacy. Programmes maintaining regular home visits had higher patient satisfaction levels. Our findings suggest that there were differential changes in self-management outcomes following CHBC interventions. While self-management support through CHBC programmes was evident, CHBC providers require continuous training, supervision and sustainable funding to strengthen their contribution. Furthermore, sociodemographic and condition-related factors should inform the design of future interventions to optimise outcomes. This study provides a systematic evaluation of self-management outcomes for a heterogeneous chronically ill patient population and highlights the potential and relevant contribution of CHBC programmes in improving chronic care within sub-Saharan Africa."

Matèries

Atenció domiciliària, Malalties cròniques

Matèries (anglès)

Home care services, Chronic diseases

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Articles publicats en revistes (ISGlobal)

Citació

ANGWENYI, Vibian, BUNDERS-AELEN, Joske, CRIEL, Bart, LAZARUS, Jeffrey v., AANTJES, Carolien. An evaluation of self-management outcomes among chronic care
                patients in community home-based care programmes in rural
                Malawi: A 12-month follow-up study.. _Health & Social Care In The Community_. 2021. Vol.  vol 29, núm. num 2, pàgs. 353-368. [consulta: 23 de gener de 2026]. ISSN: 0966-0410. [Disponible a: https://hdl.handle.net/2445/183130]

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