title: Self-management interventions: Proposal and validation of a new operational definition.
abstract: Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management interventions and determine its discriminative performance compared with other operational definitions.
  
  
  
  Systematic review of definitions of self-management interventions and consensus meetings with self-management research experts and practitioners.
  
  
  
  Self-management interventions were defined as interventions that aim to equip patients with skills to actively participate and take responsibility in the management of their chronic condition in order to function optimally through at least knowledge acquisition and a combination of at least two of the following: stimulation of independent sign/symptom monitoring, medication management, enhancing problem-solving and decision-making skills for medical treatment management, and changing their physical activity, dietary, and/or smoking behavior. This definition substantially reduced the number of selected studies (255 of 750). In two preliminary expert meetings (n = 6), the proposed definition was identifiable for self-management research experts and practitioners (80% and 60% agreement, respectively).
  
  
  
  Future systematic reviews must carefully consider the operational definition of the intervention studied because the definition influences the selection of studies on which conclusions and recommendations for clinical practice are based.
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, HP W01.121, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands. Electronic address: n.h.jonkman@vu.nl.
authors.forename: Nini H
authors.initials: NH
authors.lastname: Jonkman
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, HP W01.121, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.affiliation: Lienhard School of Nursing, College of Health Professions, Pace University, New York, NY, USA.
authors.forename: Lillie M
authors.initials: LM
authors.lastname: Shortridge-Baggett
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, HP W01.121, Heidelberglaan 100, 3508 GA Utrecht, The Netherlands.
authors.forename: Jaap C A
authors.initials: JC
authors.lastname: Trappenburg
mesh_terms: D002908:Chronic Disease; D006801:Humans; D015203:Reproducibility of Results; D012196:Review Literature as Topic; D012648:Self Care / Q000145:classification* / Q000379:methods*
keywords: Chronic disease; Complex interventions; Definition; Primary care; Self-management interventions; Systematic review