title: Improving confidence for self care in patients with depression and chronic illnesses.
abstract: The aim of this study was to examine whether patients who received a multicondition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy was positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention that combined self-management support and collaborative care management. At 6 and 12 month outcomes the intervention group showed significant improvements over the usual care group in confidence in ability to follow through with medical regimens important to managing their conditions and to maintain lifestyle changes even during times of stress. Improvements in self care-efficacy were significantly related to improvements in depression, and early improvements in confidence to maintain lifestyle changes even during times of stress explained part of the observed subsequent improvements in depression.
authors: Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA 98101, USA. ludman.e@ghc.org
authors: Evette J
authors: EJ
authors: Ludman
authors: Do
authors: D
authors: Peterson
authors: Wayne J
authors: WJ
authors: Katon
authors: Elizabeth H B
authors: EH
authors: Lin
authors: Michael
authors: M
authors: Von Korff
authors: Paul
authors: P
authors: Ciechanowski
authors: Bessie
authors: B
authors: Young
authors: Jochen
authors: J
authors: Gensichen
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002908:Chronic Disease / Q000523:psychology; D003327:Coronary Disease / Q000097:blood / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000150:complications / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000523:psychology; D003920:Diabetes Mellitus / Q000097:blood / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010348:Patient Care Team; D010353:Patient Education as Topic / Q000379:methods*; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008077:Lipoproteins, LDL
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