title: A 12-month follow-up study of self-management training for people with chronic disease: are changes maintained over time?
abstract: OBJECTIVE
  A previous study reported some improved outcomes at 4-month follow-up after attendance on a lay-led, chronic disease self-management course (CDSMC). The purpose of this study was to determine whether changes were maintained over time (i.e. at 12 months) and to describe participants' current use of self-management techniques.
  
  
  METHODS
  The study was a 12-month follow-up of a sample of 171 participants who attended a CDSMC in the UK.
  
  
  METHODS
  Data were collected by self-administered questionnaires mailed to participants 12 months after they commenced a CDSMC and via telephone interviews with a sub-sample.
  
  
  RESULTS
  The sample had a mean age of 54 years, mean disease duration of 16 years, 73% were women, and chronic diseases included endometriosis, depression, diabetes, myalgic encephalomyelitis, osteoporosis and polio. The significant improvements in outcomes identified at 4 months (i.e. cognitive symptom management, self-efficacy, communication with physician, fatigue, anxious and depressed moods and health distress) were sustained at 12 months. No significant changes between 4- and 12-month assessments were found on any study variables. Interview data confirmed that participants continued to use some of the self-management techniques learned on the course.
  
  
  CONCLUSIONS
  Attendance on the CDSMC may lead to longer-term changes in key outcomes such as self-efficacy, use of some self-management behaviours and some aspects of health status (e.g. fatigue, depressed mood).
authors.affiliation: School of Health and Social Sciences, Coventry University, UK. j.barlow@coventry.ac.uk
authors.forename: J H
authors.initials: JH
authors.lastname: Barlow
authors.forename: C C
authors.initials: CC
authors.lastname: Wright
authors.forename: A P
authors.initials: AP
authors.lastname: Turner
authors.forename: G V
authors.initials: GV
authors.lastname: Bancroft
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006126:Group Processes; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D012803:Sick Role; D011795:Surveys and Questionnaires