Self-management interventions for chronic disease: a systematic scoping review

• Published in: Clinical rehabilitation Vol. 28; no. 11; pp. 1067 - 1077
• Main Authors: Richardson, Julie, Loyola-Sanchez, Adalberto, Sinclair, Susanne, Harris, Jocelyn, Letts, Lori, MacIntyre, Norma J, Wilkins, Seanne, Burgos-Martinez, Gabriela, Wishart, Laurie, McBay, Cathy, Martin Ginis, Kathleen
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01-11-2014; Sage Publications Ltd
• Subjects: Adult; Aged; Chronic Disease - rehabilitation; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Occupational Therapy - methods; Pain Management - methods; Pain Measurement; Patient Education as Topic - methods; Physical Therapy Modalities; Prognosis; Self Care - methods; Systematic review; Treatment Outcome; rehabilitation; physical therapy modalities; Chronic disease; occupational therapy; self-care; scoping review
• ISSN: 0269-2155; 1477-0873
• DOI: 10.1177/0269215514532478

Objective:
To investigate the contributions of physiotherapy and occupational therapy to self-management interventions and the theoretical models used to support these interventions in chronic disease.
Data sources:
We conducted two literature searches to identify studies that evaluated self-management interventions involving physiotherapists and occupational therapists in MEDLINE, the Cochrane Library, CINAHL, EMBASE, AMED (Allied and Complementary Medicine), SPORTdiscus, and REHABDATA databases.
Study selection:
Four investigator pairs screened article title and abstract, then full text with inclusion criteria. Selected articles (n = 57) included adults who received a chronic disease self-management intervention, developed or delivered by a physiotherapist and/or an occupational therapist compared with a control group.
Data extraction:
Four pairs of investigators performed independent reviews of each article and data extraction included: (a) participant characteristics, (b) the self-management intervention, (c) the comparison intervention, (d) outcome measures, construct measured and results.
Data synthesis:
A total of 47 articles reported the involvement of physiotherapy in self-management compared with 10 occupational therapy articles. The type of chronic condition produced different yields: arthritis n = 21 articles; chronic obstructive pulmonary disease and chronic pain n = 9 articles each. The theoretical frameworks most frequently cited were social cognitive theory and self-efficacy theory. Physical activity was the predominant focus of the self-management interventions. Physiotherapy programmes included disease-specific education, fatigue, posture, and pain management, while occupational therapists concentrated on joint protection, fatigue, and stress management.
Conclusions:
Physiotherapists and occupational therapists make moderate contributions to self-management interventions. Most of these interventions are disease-specific and are most frequently based on the principles of behaviour change theories.