title: Validation of Self-Management Screening (SeMaS), a tool to facilitate personalised counselling and support of patients with chronic diseases.
abstract: BACKGROUND
  A rising number of people with chronic conditions is offered interventions to enhance self-management. The responsiveness of individuals to these interventions depends on patient characteristics. We aimed to develop and validate a tool to facilitate personalised counselling and support for self-management in patients with chronic diseases in primary care.
  
  
  METHODS
  We drafted a prototype of the tool for Self-Management Screening (SeMaS), comprising 27 questions that were mainly derived from validated questionnaires. To reach high content validity, we performed a literature review and held focus groups with patients and healthcare professionals as input for the tool. The characteristics self-efficacy, locus of control, depression, anxiety, coping, social support, and perceived burden of disease were incorporated into the tool. Three items were added to guide the type of support or intervention, being computer skills, functioning in groups, and willingness to perform self-monitoring. Subsequently, the construct and criterion validity of the tool were investigated in a sample of 204 chronic patients from two primary care practices. Patients filled in the SeMaS and a set of validated questionnaires for evaluation of SeMaS. The Patient Activation Measure (PAM-13), a generic instrument to measure patient health activation, was used to test the convergent construct validity.
  
  
  RESULTS
  Patients had a mean age of 66.8 years and 46.6 % was female. 5.9 % did not experience any barrier to self-management, 28.9 % experienced one minor or major barrier, and 30.4 % two minor or major barriers. Compared to the criterion measures, the positive predictive value of the SeMaS characteristics ranged from 41.5 to 77.8 % and the negative predictive value ranged from 53.3 to 99.4 %. Crohnbach's alpha for internal consistency ranged from 0.56 to 0.87, except for locus of control (α = 0.02). The regression model with PAM-13 as a dependent variable showed that the SeMaS explained 31.7 % (r(2) = 0.317) of the variance in the PAM-13 score.
  
  
  CONCLUSIONS
  SeMaS is a short validated tool that can signal potential barriers for self-management that need to be addressed in the dialogue with the patient. As such it can be used to facilitate personalised counselling and support to enhance self-management in patients with chronic conditions in primary care.
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, P.O. Box 9101, 114, 6500, HB, Nijmegen, The Netherlands. nathalie.eikelenboom@radboudumc.nl.|DOH care group, P.O. Box 704, , 5600, AS, Eindhoven, The Netherlands. nathalie.eikelenboom@radboudumc.nl.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Eikelenboom
authors.affiliation: DOH care group, P.O. Box 704, , 5600, AS, Eindhoven, The Netherlands. i.smeele@upcmail.nl.
authors.forename: Ivo
authors.initials: I
authors.lastname: Smeele
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, P.O. Box 9101, 114, 6500, HB, Nijmegen, The Netherlands. marjan.faber@radboudumc.nl.
authors.forename: Marjan
authors.initials: M
authors.lastname: Faber
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, P.O. Box 9101, 114, 6500, HB, Nijmegen, The Netherlands. annelies.jacobs@radboudumc.nl.
authors.forename: Annelies
authors.initials: A
authors.lastname: Jacobs
authors.affiliation: Doen en blijven doen, Icaruslaan 39, 5631 LH, Eindhoven, The Netherlands. frankverhulst@onsneteindhoven.nl.
authors.forename: Frank
authors.initials: F
authors.lastname: Verhulst
authors.affiliation: Philips Research, High Tech Campus 34, 5656 AE, Eindhoven, The Netherlands. Joyca.lacroix@philips.com.
authors.forename: Joyca
authors.initials: J
authors.lastname: Lacroix
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, P.O. Box 9101, 114, 6500, HB, Nijmegen, The Netherlands. michel.wensing@radboudumc.nl.
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.affiliation: Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ healthcare, P.O. Box 9101, 114, 6500, HB, Nijmegen, The Netherlands. jan.vanlieshout@radboudumc.nl.
authors.forename: Jan
authors.initials: J
authors.lastname: van Lieshout
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D001007:Anxiety / Q000523:psychology; D017281:Cost of Illness; D003376:Counseling / Q000379:methods*; D003863:Depression / Q000523:psychology; D005260:Female; D020773:Headache Disorders / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007389:Internal-External Control; D008297:Male; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires