A review of the efficacy of the self-management model on health outcomes in community-residing older adults with arthritis.
BACKGROUND
Chronic disease and disability have a significant impact on individuals, families, and society, resulting in limitations in personal care, premature loss of wages, higher mortality rates, and overall poor quality of life. Arthritis is a painful disease that limits physical activity, social functioning, and mental health and is hallmarked by an increasing prevalence in community-dwelling older adults. Self-management strategies reduce pain and disability while improving self-efficacy and quality of life.


OBJECTIVE
The purpose of this review is to evaluate the efficacy of the self-management program in adults with arthritis on the outcome of functional disability.


METHODS
Literature review. Search strategy included MEDLINE, CINAHL, and the Cochrane Library from 1985 to 2008 for studies using self-management interventions.


RESULTS
Across studies of chronic disease, effect sizes were moderate for most variables. Subgroup ana- lyses for arthritis only demonstrated a greater magnitude of effect in variables related to functional health.


CONCLUSIONS
While this review suggests small efficacy in the self-management program, with improvement in certain cognitive-behavioral markers for self-management, the functional gains that can be achieved in a growing older adult population translate into a larger effect overall.
Nuñez
Diane E
DE
Hartford Evercare Predoctoral Scholar, Hartford Center of Excellence in Geriatric Nursing, Arizona State University, Phoenix, AZ 85003, USA. diane.nunez@asu.edu
Keller
Colleen
C
Ananian
Cheryl Der
CD
D000203:Activities of Daily Living; D000368:Aged; D001168:Arthritis / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D002908:Chronic Disease; D017281:Cost of Illness; D004059:Diffusion of Innovation; D015987:Effect Modifier, Epidemiologic; D055317:Evidence-Based Practice / Q000458:organization & administration*; D005081:Exercise Therapy; D015577:Geriatric Assessment; D006801:Humans; D008962:Models, Theoretical; D010353:Patient Education as Topic; D015995:Prevalence; D011788:Quality of Life; D012107:Research Design; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D016896:Treatment Outcome