Benefits for elders with vulnerable health from the Chronic Disease Self-management Program (CDSMP) at short and longer term.
BACKGROUND
When health declines, older persons may benefit from an intervention program that strengthens their self-management and empowers them to keep in control of their own body and life. Therefore we conducted a Randomized Controlled Trial using the Chronic Disease Self-Management Program (CDSMP) in a sample of 169 older persons in frail health and in need of elderly care.


METHODS
We assessed psychological coping resources and wellbeing, pre- and posttreatment and at 6-month follow-up, and investigated whether specific subgroups would benefit in particular from the intervention.


RESULTS
The CDSMP appeared effective with respect to sense of mastery but only in the lower educated participants (p < .05). Furthermore, the intervention stabilized valuation of life in participants, whereas in the controls valuation of life decreased. The high appreciation score and low drop-out are indicative for the applicability of the CDSMP for this specific target group.


CONCLUSIONS
We recommend integration of the ingredients of the program into the daily healthcare practice of professionals working with vulnerable older persons. This would involve professional guidance starting from interpersonal equality and emphasising a persons possibilities given their physical or cognitive limitations. This will help older vulnerable persons to focus on their own attainable goals and to experience being successful.


BACKGROUND
The trial was registered in the Dutch Trial Register as NTR 1173 at 08-03-2008; 'Is selfmanagement benefical for well-being of average older persons?' http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1173.
Department of Epidemiology & Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. angele.jonker@jonkerszorg.nl.
Angèle A G C
AA
Jonker
Department of Epidemiology & Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. H.Comijs@ggzingeest.nl.
Hannie C
HC
Comijs
Department of Epidemiology & Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. kees@kknipscheer.nl.
Kees C P M
KC
Knipscheer
Department of Epidemiology & Biostatistics, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. djh.deeg@vumc.nl.
Dorly J H
DJ
Deeg
D000223:Adaptation, Psychological / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015897:Comorbidity; D003695:Delivery of Health Care; D004522:Educational Status; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D015397:Program Evaluation; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy