Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial

• Published in: Bulletin of the World Health Organization Vol. 81; no. 3; pp. 174 - 182
• Main Authors: FU DONGBO, FU HUA, MCGOWAN, Patrick, YI-E, Shen, ZHU LIZHEN, YANG HUIQIN, MAO JIANGUO, ZHU SHITAI, DING YONGMING, WEI ZHIHUA
• Format: Journal Article
• Language: English; Portuguese
• Published: Genève Organisation mondiale de la santé 01.01.2003; World Health Organization; The World Health Organization
• Subjects: Advance directives; Aged; Arthritis; Arthritis/therapy; Behavior; Biological and medical sciences; Cardiovascular disease; Care and treatment; Cerebrovascular accident/therapy; China; China (People's Republic); Chronic Disease - therapy; Chronic diseases; Chronic illnesses; Chronically ill; Clinical trials; Community health care; Community Health Services; Congestive/therapy; Coronary disease/therapy; Cultural Characteristics; Diabetes; Diabetes mellitus/therapy; Disease Management; Exercise; Female; General populations; Health aspects; Health Policy & Services; Health services; Health Services Research; Heart; Heart failure; Humans; Hypertension; Hypertension/therapy; Life style; Lung diseases; Male; Management; Medical personnel; Medical records; Medical sciences; Medical sector; Middle Aged; Obstructive/therapy; Outcome Assessment (Health Care); Patient education; Prevention and actions; Problem solving; Program Evaluation; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Randomized controlled trials; Self Care; Stroke; Symptom management; Tropical medicine; Asia; China; Human; Evaluation; Sanitary program; Chronic; Treatment; Disease; Controlled therapeutic trial; Public health; Evaluation résultats (Santé); Community health services; Moeurs; Evaluation programme; Características culturales; Coronariopatía; Diabète; Arthritis; Vaisseaux coronaires; Randomized controlled trials; Insuficiencia cardíaca congestiva; Cultural characteristics; Servicios de salud comunitaria; Auto-traitement; Maladies; Bronchopneumopathies obstructives; China; Accidente cerebrovascular; Maladie chronique; Cerebrovascular accident; Accident vasculaire cérébral; Chine; Obstructive; Essai clinique randomisé; Hypertension; Heart failure; Self care; Evaluación de programas; Chronic disease; Insuffisance cardiaque; Lung diseases; Diabetes mellitus; Evaluación de resultado (Atención de salud); Program evaluation; Hypertension artérielle; Coronary disease; Neumopatías obstructivas; Ensayos controlados aleatorios; Enfermedad crónica; Outcome assessment (Health care); Service public santé; Artritis; Congestive; Autocuidado; Arthrite
• ISSN: 0042-9686; 1564-0604
• DOI: 10.1590/S0042-96862003000300007

To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program (CDSMP). A randomized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment (waiting-list controls) in five urban communities in Shanghai, China. Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately; those in the control group received the same education and book six months later. In total, 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension, heart disease, chronic lung disease, arthritis, stroke, or diabetes who lived in communities were assigned randomly to treatment (n = 526) and control (n = 428) groups. Overall, 430 (81.7%) and 349 (81.5%) patients in the treatment and control groups completed the six-month study. Patients who received treatment had significant improvements in weekly minutes of aerobic exercise, practice of cognitive symptom management, self-efficacy to manage own symptoms, and self-efficacy to manage own disease in general compared with controls. They also had significant improvements in eight indices of health status and, on average, fewer hospitalizations. When implemented in Shanghai, the CDSMP was acceptable culturally to Chinese patients. The programme improved participants' health behaviour, self-efficacy, and health status and reduced the number of hospitalizations six months after the course. The locally based delivery model was integrated into the routine of community government organizations and community health services. Chinese lay leaders taught the CDSMP courses as successfully as professionals.