title: The effectiveness of interventions to enhance self-management support competencies in the nursing profession: a systematic review.
abstract: OBJECTIVE
  The aim of this study was to explore the effectiveness and effective components of training interventions to enhance nurses' competencies in self-management support in chronic care.
  
  
  BACKGROUND
  The growing burden of chronic diseases puts an increasing focus on nurses' self-management support of people living with a chronic illness. The most effective method to train nurses' competencies in self-management support remains unclear.
  
  
  METHODS
  Systematic literature review.
  
  
  METHODS
  PubMed, CINAHL, Cochrane CENTRAL, EMBASE, Web of Science, ERIC and PsycARTICLES databases were searched up to August 2015.
  
  
  METHODS
  Eligible studies reported on training interventions to enhance chronic care self-management support competencies in nurses. Outcomes were defined as trainees' reactions to the training (level 1), changes in trainees' competencies (level 2) or changes in trainees' performance in practice (level 3) concerning self-management support. Risk of bias was assessed. Level 1 outcomes were synthesized narratively. Standardized mean differences were calculated per study for level 2 and 3 outcomes.
  
  
  RESULTS
  In total, 25 studies were included. Twelve of these studies included level 1 outcomes, eight studies included level 2 outcomes and 10 studies included level 3 outcomes. Effect sizes in favour of training ranged from -0·36 - 1·56 (level 2) and from 0·06 - 5·56 (level 3). Theory-driven training interventions with time to practice, (video) feedback and follow-up generated the most training effects. Caution is needed due to the inconsistent study quality.
  
  
  CONCLUSIONS
  To date, there is a knowledge gap concerning the most effective method to train nurses' competencies in self-management support. More well-designed, longitudinal studies are needed.
authors.affiliation: Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Belgium.
authors.forename: Veerle
authors.identifier: http://orcid.org/0000-0002-2973-3684
authors.initials: V
authors.lastname: Duprez
authors.affiliation: Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Belgium.|Department Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Tina
authors.initials: T
authors.lastname: Vandecasteele
authors.affiliation: Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Belgium.|Department Health Care, VIVES University College, Roeselare, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Verhaeghe
authors.affiliation: Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Belgium.|School of Health Sciences, Nursing and Midwifery, University of Surrey, United Kingdom.
authors.forename: Dimitri
authors.identifier: http://orcid.org/0000-0003-3080-8716
authors.initials: D
authors.lastname: Beeckman
authors.affiliation: Department of Public Health, University Centre for Nursing and Midwifery, Ghent University, Belgium.|Ghent, University Hospital, Belgium.
authors.forename: Ann
authors.identifier: http://orcid.org/0000-0003-3576-7159
authors.initials: A
authors.lastname: Van Hecke
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000451:nursing*; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D004506:Education, Nursing / Q000379:methods*; D006801:Humans; D009723:Nurse-Patient Relations; D016032:Randomized Controlled Trials as Topic; D000073278:Self-Management / Q000379:methods*; D012944:Social Support
keywords: chronic illness; competencies; education; effectiveness; intervention; literature review; nursing; self-management; self-management support; systematic review; training