Impact of an occupation-based self-management programme on chronic disease management

Abstract

Introduction: There is a need for the development and evaluation of occupational therapy interventions enabling participation and contributing to self-management for individuals with multiple chronic conditions. This pilot study aimed to assess the feasibility and potential impact of an occupation-based self-management programme for community living individuals with multiple chronic conditions.

Methods: Sixteen participants completed a six-week programme. Assessments were conducted at baseline, immediately post-intervention and at eight-week follow-up. Sixteen participants provided immediate follow-up data and 15 participants provided eight-week follow-up data. Outcome measures included participation in occupations; perceptions of occupational performance and satisfaction; self-efficacy; depression, anxiety and quality of life. Focus groups explored participants' perceptions of the programme.

Results: The findings are promising and indicate that the programme delivery was feasible. Significant differences were found immediately post-intervention in frequency of activity participation (P = 0.008), including domestic (P = 0.040) and work/leisure activities (P = 0.015), self-perceptions of occupational performance (P = 0.017) and satisfaction with same (P = 0.023). At eight-week follow-up, significant differences continued to be found in frequency of activity participation (P = 0.018), including work/leisure activities (P = 0.038), perceptions of occupational performance (P = 0.010) and satisfaction (P = 0.008) and self-efficacy (P = 0.050). No differences were found in anxiety, depression or quality of life at follow-up periods. Focus group data supported the programme's impact on activity participation and self-efficacy.

Conclusion: Despite the small sample in this pilot study there were significant improvements in occupational performance and the findings provide support for the programme. However, there is a need to test the intervention rigorously with a definitive randomised trial in a primary care setting.