Article

Evidence shows that effective self-management behaviors have the
potential to improve health outcomes, quality of life, self-efficacy and reduce
morbidity, emergency visits and costs of care. A better understanding of
self-management interventions (i.e. programs that help with managing symptoms,
treatment, physical and psychological consequences) is needed to achieve a
positive impact on health because most children with a disability now live well
into adulthood. METHOD: A systematic review of self-management interventions for
school age youth with physical disabilities was undertaken to assess their
effectiveness. Comprehensive electronic searches using international web-based
reference libraries were conducted for peer-reviewed and gray literature
published between 1980 and January 2012. Eligible studies examined the
effectiveness of self-management interventions for children and youth between 6
and 18 years of age with congenital or acquired physical disabilities. Studies
needed to include a comparison group (e.g. single group pre/post-test design) and
at least one quantifiable health-related outcome. RESULTS: Of the 2184 studies
identified, six met the inclusion criteria; two involved youth with spina bifida
and four with juvenile arthritis. The majority of the interventions ran several
sessions for at least 3 months by a trained interventionist or clinician, had
one-to-one sessions and meetings, homework activities and parental involvement.
Although outcomes varied between the studies, all of the interventions reported
at least one significant improvement in either overall self-management skills or
a specific health behavior. CONCLUSIONS: While self-management interventions have
the potential to improve health behaviors, there were relatively few rigorously
designed studies identified. More studies are needed to document the outcomes of
self-management interventions, especially their most effective characteristics
for children and youth with physical disabilities. Implications for
Rehabilitation There is some evidence to suggest that self-management
interventions for children and youth with spina bifida and arthritis can improve
self-management behaviors and health outcomes. Parents' involvement should be
considered in encouraging self-management behaviors at different stages of their
child's development. Much work is needed to explore the longer term implications
of self-management interventions for youth with physical disabilities as well as
the impact on health care utilization.

Langue : ANGLAIS