title: Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands.
abstract: BACKGROUND
  Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management.
  
  
  METHODS
  Survey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics.
  
  
  RESULTS
  Chronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not.
  
  
  CONCLUSIONS
  Chronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Netherlands. Electronic address: l.vanhoutum@nivel.nl.
authors.forename: L
authors.initials: L
authors.lastname: van Houtum
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Heijmans
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Rijken
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Netherlands; Department of Sociology and Department of Human Geography, Utrecht University, Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Groenewegen
mesh_terms: D002908:Chronic Disease / Q000451:nursing / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D008137:Longitudinal Studies; D009426:Netherlands; D010361:Patients / Q000523:psychology*; D011787:Quality of Health Care / Q000458:organization & administration; D012648:Self Care / Q000379:methods; D011795:Surveys and Questionnaires
keywords: Chronic disease; Nurses; Quality of healthcare; Self-care