Improving confidence for self care in patients with depression and chronic illnesses

Behav Med. 2013;39(1):1-6. doi: 10.1080/08964289.2012.708682.

Abstract

The aim of this study was to examine whether patients who received a multicondition collaborative care intervention for chronic illnesses and depression had greater improvement in self-care knowledge and efficacy, and whether greater knowledge and self-efficacy was positively associated with improved target outcomes. A randomized controlled trial with 214 patients with comorbid depression and poorly controlled diabetes and/or coronary heart disease tested a 12-month team-based intervention that combined self-management support and collaborative care management. At 6 and 12 month outcomes the intervention group showed significant improvements over the usual care group in confidence in ability to follow through with medical regimens important to managing their conditions and to maintain lifestyle changes even during times of stress. Improvements in self care-efficacy were significantly related to improvements in depression, and early improvements in confidence to maintain lifestyle changes even during times of stress explained part of the observed subsequent improvements in depression.

Trial registration: ClinicalTrials.gov NCT00468676.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Blood Glucose / physiology
  • Blood Pressure / physiology
  • Chronic Disease / psychology
  • Coronary Disease / blood
  • Coronary Disease / psychology*
  • Coronary Disease / therapy
  • Depression / complications
  • Depression / psychology*
  • Depressive Disorder / complications
  • Depressive Disorder / psychology
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / psychology*
  • Diabetes Mellitus / therapy
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Lipoproteins, LDL / blood
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Care Team
  • Patient Education as Topic / methods*
  • Self Care / psychology*
  • Self Efficacy*
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Lipoproteins, LDL

Associated data

  • ClinicalTrials.gov/NCT00468676