A review of the efficacy of the self-management model on health outcomes in community-residing older adults with arthritis

Worldviews Evid Based Nurs. 2009;6(3):130-48. doi: 10.1111/j.1741-6787.2009.00157.x. Epub 2009 Jul 27.


Background: Chronic disease and disability have a significant impact on individuals, families, and society, resulting in limitations in personal care, premature loss of wages, higher mortality rates, and overall poor quality of life. Arthritis is a painful disease that limits physical activity, social functioning, and mental health and is hallmarked by an increasing prevalence in community-dwelling older adults. Self-management strategies reduce pain and disability while improving self-efficacy and quality of life.

Aims: The purpose of this review is to evaluate the efficacy of the self-management program in adults with arthritis on the outcome of functional disability.

Methods: Literature review. Search strategy included MEDLINE, CINAHL, and the Cochrane Library from 1985 to 2008 for studies using self-management interventions.

Results: Across studies of chronic disease, effect sizes were moderate for most variables. Subgroup ana- lyses for arthritis only demonstrated a greater magnitude of effect in variables related to functional health.

Conclusions: While this review suggests small efficacy in the self-management program, with improvement in certain cognitive-behavioral markers for self-management, the functional gains that can be achieved in a growing older adult population translate into a larger effect overall.

Publication types

  • Review

MeSH terms

  • Activities of Daily Living
  • Aged
  • Arthritis / epidemiology
  • Arthritis / psychology
  • Arthritis / rehabilitation*
  • Chronic Disease
  • Cost of Illness
  • Diffusion of Innovation
  • Effect Modifier, Epidemiologic
  • Evidence-Based Practice / organization & administration*
  • Exercise Therapy
  • Geriatric Assessment
  • Humans
  • Models, Theoretical*
  • Patient Education as Topic
  • Prevalence
  • Quality of Life
  • Research Design
  • Self Care / methods*
  • Self Efficacy
  • Treatment Outcome