title: Improved self-management skills predict improvements in quality of life and depression in patients with chronic disorders.
abstract: Self-management programs aim to improve patients' skills to manage their chronic condition in everyday life. Improvement in self-management is assumed to bring about improvements in more distal outcomes, such as quality of life. This study aimed to test the hypothesis that changes in self-reported self-management skills observed after participation in self-management programs predict changes in both quality of life and depressive symptoms three months later.
  
  
  
  Using latent change modeling, the relationship between changes in latent variables over three time points (start and end of rehabilitation, after three months) was analysed. The sample comprised 580 patients with different chronic conditions treated in inpatient rehabilitation clinics. The influence of additional predictor variables (age, sex, perceived social support) and type of disorder as a moderator variable was also tested.
  
  
  
  Changes in self-reported self-management skills after rehabilitation predicted changes in both quality of life and depressive symptoms at the end of rehabilitation and the 3 months follow-up. These relationships remained significant after the inclusion of other predictor variables and were similar across disorders.
  
  
  
  The findings provide support for the hypothesis that improvements in proximal outcomes of self-management programs may foster improvements in distal outcomes. Further studies should investigate treatment mechanisms.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany. Electronic address: gunda.musekamp@uni-wuerzburg.de.
authors.forename: Gunda
authors.initials: G
authors.lastname: Musekamp
authors.affiliation: Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany. Electronic address: juergen.bengel@psychologie.uni-freiburg.de.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bengel
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany. Electronic address: m.schuler@uni-wuerzburg.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Schuler
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, University of Würzburg, Würzburg, Germany. Electronic address: h.faller@uni-wuerzburg.de.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000523:psychology*; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000379:methods*; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: Latent change; Patient education; Quality of life; Rehabilitation; Self-management