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Self-management interventions for chronic disease

OBJECTIVE: To investigate the contributions of physiotherapy and occupational
therapy to self-management interventions and the theoretical models used to
support these interventions in chronic disease.
DATA SOURCES: We conducted two literature searches to identify studies that evaluated self-management
interventions involving physiotherapists and occupational therapists in MEDLINE,
the Cochrane Library, CINAHL, EMBASE, AMED (Allied and Complementary Medicine),
SPORTdiscus, and REHABDATA databases. STUDY SELECTION: Four investigator pairs
screened article title and abstract, then full text with inclusion criteria.
Selected articles (n = 57) included adults who received a chronic disease
self-management intervention, developed or delivered by a physiotherapist and/or
an occupational therapist compared with a control group. DATA EXTRACTION: Four
pairs of investigators performed independent reviews of each article and data
extraction included: (a) participant characteristics, (b) the self-management
intervention, (c) the comparison intervention, (d) outcome measures, construct
measured and results. DATA SYNTHESIS: A total of 47 articles reported the
involvement of physiotherapy in self-management compared with 10 occupational
therapy articles. The type of chronic condition produced different yields:
arthritis n = 21 articles; chronic obstructive pulmonary disease and chronic pain
n = 9 articles each. The theoretical frameworks most frequently cited were social
cognitive theory and self-efficacy theory. Physical activity was the predominant
focus of the self-management interventions. Physiotherapy programmes included
disease-specific education, fatigue, posture, and pain management, while
occupational therapists concentrated on joint protection, fatigue, and stress
management. CONCLUSIONS: Physiotherapists and occupational therapists make
moderate contributions to self-management interventions. Most of these
interventions are disease-specific and are most frequently based on the
principles of behaviour change theories.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS

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