# name
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.

# metadata.dc.description.abstract[].value
"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."

# metadata.dc.relation.ispartof[].value
Health & Social Care In The Community, 2021, vol 29, num 2, p. 353-368

# metadata.dc.rights[].value
cc by-nc (c) Angwenyi, Vibian et al, 2021

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
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.