The Chronic Disease Self-Management Programme: A Phenomenological Study for Empowering Vulnerable Patients with Chronic Diseases Included in the EFFICHRONIC Project

Overview

Journal Health Expect

Publisher Wiley

Specialty Public Health

Date 2022 Jan 11

PMID 35014112

Authors

Dallal Fracso

Gerard Bourrel

Christian Jorgensen

Helene Fanton

Hein Raat

Alberto Pilotto

Graham Baker

Marta M Pisano

Rosanna Ferreira

Verushka Valsecchi

Yves-Marie Pers

Agnes Oude Engberink

Affiliations

Soon will be listed here.

Abstract

Introduction: The Chronic Disease Self-Management Programme (CDSMP) has resulted in improved health outcomes for patients. However, research has focused mainly on those with chronic conditions and has not extensively explored prevention programmes targeting individuals with specific vulnerability profiles.

Aim: This study aimed to understand the effects of the CDSMP on the lived experience of vulnerable patients included in the EFFICHRONIC project in France, based on their needs and expectations before and after participation.

Methods: We conducted a qualitative phenomenological semio-pragmatic study based on 37 in-depth interviews with 20 patients (20 before/17 after CDSMP).

Results: By transforming existential dimensions (identity, relationship with others and bodily experience), chronic illness generates new needs in the vulnerable person. By resonating with the expectations and needs of participants, the CDSMP induces motivation and a sense of belonging to a community of peers. It has enabled the participants to become actors of their own health until empowerment. Although some limitations are reported, the programme has awakened a desire in the participants to take better care of their health and to develop personal skills with, for some, a desire to become involved in health education.

Conclusion: Our phenomenological approach highlighted the resonance between the programme (its design and implementation) and the lived experience of patients, as an effective element of empowerment. This necessitates training the facilitators to elicit the lived experience of patients. Furthermore, as a patient-centred approach is required, the facilitators need to learn how to adapt the design of the programme to the singularity of the patient.

Patient Or Public Contribution: Patients provided the data that were collected through in-depth interviews, and their experiences before and after the programme were analysed.

Citing Articles

Effects of the Stanford Chronic Conditions Model on Behavioral and Clinical Indicators in Saudi Arabia: A Prospective Quasi-Experimental Study.

Bahari G, Kerari A, Alsadoun A, Alnassar M J Multidiscip Healthc. 2025; 18():147-156.

PMID: 39834514 PMC: 11745170. DOI: 10.2147/JMDH.S501331.

Obstacles and Opportunities for Albuminuria Testing On the Basis of the Perspective of Primary Care: A Qualitative Study.

Oude Engberink A, Marc J, Renk E, Serayet P, Bourrel G, Moranne O Clin J Am Soc Nephrol. 2024; 20(3):367-376.

PMID: 39601684 PMC: 11906011. DOI: 10.2215/CJN.0000000620.

Chronic illness experience in the context of resource-limited settings: a concept analysis.

Nkambule E, Msiska G Int J Qual Stud Health Well-being. 2024; 19(1):2378912.

PMID: 39007854 PMC: 11251436. DOI: 10.1080/17482631.2024.2378912.

Impact of Chronic Disease Self-Management Program on the Self-Perceived Health of People in Areas of Social Vulnerability in Asturias, Spain.

Garcia-Ovejero E, Pisano-Gonzalez M, Salcedo-Diego I, Serrano-Gallardo P Healthcare (Basel). 2024; 12(8).

PMID: 38667573 PMC: 11049834. DOI: 10.3390/healthcare12080811.

Evaluating the Effectiveness of a Self-Management Program on Patients Living with Chronic Diseases.

Bahari G, Kerari A Risk Manag Healthc Policy. 2024; 17:487-496.

PMID: 38449511 PMC: 10916514. DOI: 10.2147/RMHP.S451692.

References

Kelly E, Fulginiti A, Pahwa R, Tallen L, Duan L, Brekke J . A pilot test of a peer navigator intervention for improving the health of individuals with serious mental illness. Community Ment Health J. 2013; 50(4):435-46. DOI: 10.1007/s10597-013-9616-4. View

Garcia-Caselles P, Miralles R, Arellano M, Torres R, Aguilera A, Pi-Figueras M . Validation of a modified version of the Gijon's social-familial evaluation scale (SFES): the "Barcelona SFES Version", for patients with cognitive impairment. Arch Gerontol Geriatr Suppl. 2004; (9):201-6. DOI: 10.1016/j.archger.2004.04.028. View

Ebrahimi Belil F, Alhani F, Ebadi A, Kazemnejad A . Self-Efficacy of People with Chronic Conditions: A Qualitative Directed Content Analysis. J Clin Med. 2018; 7(11). PMC: 6262549. DOI: 10.3390/jcm7110411. View

Donnelly S, Manning M, Mannan H, Wilson A, Kroll T . Renegotiating dimensions of the self: A systematic review and qualitative evidence synthesis of the lived experience of self-managing rheumatoid arthritis. Health Expect. 2020; 23(6):1388-1411. PMC: 7752197. DOI: 10.1111/hex.13122. View

Tong A, Sainsbury P, Craig J . Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007; 19(6):349-57. DOI: 10.1093/intqhc/mzm042. View

Liu S, Wrosch C, Morin A, Quesnel-Vallee A, Pruessner J . Changes in self-esteem and chronic disease across adulthood: A 16-year longitudinal analysis. Soc Sci Med. 2019; 242:112600. DOI: 10.1016/j.socscimed.2019.112600. View

Mackey L, Doody C, L Werner E, Fullen B . Self-Management Skills in Chronic Disease Management: What Role Does Health Literacy Have?. Med Decis Making. 2016; 36(6):741-59. DOI: 10.1177/0272989X16638330. View

Gobeil-Lavoie A, Chouinard M, Danish A, Hudon C . Characteristics of self-management among patients with complex health needs: a thematic analysis review. BMJ Open. 2019; 9(5):e028344. PMC: 6538095. DOI: 10.1136/bmjopen-2018-028344. View

Robles-Silva L . The caregiving trajectory among poor and chronically ill people. Qual Health Res. 2008; 18(3):358-68. DOI: 10.1177/1049732307313753. View

10.

Chapel J, Ritchey M, Zhang D, Wang G . Prevalence and Medical Costs of Chronic Diseases Among Adult Medicaid Beneficiaries. Am J Prev Med. 2017; 53(6S2):S143-S154. PMC: 5798200. DOI: 10.1016/j.amepre.2017.07.019. View

11.

Senkowski D, Heinz A . Chronic pain and distorted body image: Implications for multisensory feedback interventions. Neurosci Biobehav Rev. 2016; 69:252-9. DOI: 10.1016/j.neubiorev.2016.08.009. View

12.

Ahn S, Basu R, Smith M, Jiang L, Lorig K, Whitelaw N . The impact of chronic disease self-management programs: healthcare savings through a community-based intervention. BMC Public Health. 2013; 13:1141. PMC: 3878965. DOI: 10.1186/1471-2458-13-1141. View

13.

Schillinger D, Handley M, Wang F, Hammer H . Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care. 2009; 32(4):559-66. PMC: 2660485. DOI: 10.2337/dc08-0787. View

14.

Christensen N, Drejer S, Burns K, Lundstrom S, Hempler N . A Qualitative Exploration of Facilitators and Barriers for Diabetes Self-Management Behaviors Among Persons with Type 2 Diabetes from a Socially Disadvantaged Area. Patient Prefer Adherence. 2020; 14:569-580. PMC: 7073429. DOI: 10.2147/PPA.S237631. View

15.

Smith M, Towne S, Herrera-Venson A, Cameron K, Kulinski K, Lorig K . Dissemination of Chronic Disease Self-Management Education (CDSME) Programs in the United States: Intervention Delivery by Rurality. Int J Environ Res Public Health. 2017; 14(6). PMC: 5486324. DOI: 10.3390/ijerph14060638. View

16.

Marsh C, Peacock R, Sheard L, Hughes L, Lawton R . Patient experience feedback in UK hospitals: What types are available and what are their potential roles in quality improvement (QI)?. Health Expect. 2019; 22(3):317-326. PMC: 6543142. DOI: 10.1111/hex.12885. View

17.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M . Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008; 337:a1655. PMC: 2769032. DOI: 10.1136/bmj.a1655. View

18.

Cantarero-Prieto D, Pascual-Saez M, Blazquez-Fernandez C . Social isolation and multiple chronic diseases after age 50: A European macro-regional analysis. PLoS One. 2018; 13(10):e0205062. PMC: 6200202. DOI: 10.1371/journal.pone.0205062. View

19.

Chen M, Li P, Lin F . Influence of structured telephone follow-up on patient compliance with rehabilitation after total knee arthroplasty. Patient Prefer Adherence. 2016; 10:257-64. PMC: 4780401. DOI: 10.2147/PPA.S102156. View

20.

Hajat C, Stein E . The global burden of multiple chronic conditions: A narrative review. Prev Med Rep. 2018; 12:284-293. PMC: 6214883. DOI: 10.1016/j.pmedr.2018.10.008. View