2026-04-17T03:20:33Zhttps://recercat.cat/oai/requestoai:recercat.cat:2445/1831302025-11-19T21:57:37Zcom_2072_1057col_2072_478917
RECERCAT
author
Angwenyi, Vibian
author
Bunders-Aelen, Joske
author
Criel, Bart
author
Lazarus, Jeffrey V.
author
Aantjes, Carolien
2022-02-14T07:48:21Z2022-02-14T07:48:21Z20212022-02-11T19:00:46Z
"This paper investigates the impact of community
home-based care (CHBC) on self-management outcomes for
chronically ill patients in rural Malawi. A pre- and
post-evaluation survey was administered among 140 chronically
ill patients with HIV and non-communicable diseases, newly
enrolled in four CHBC programmes. We translated, adapted and
administered scales from the Stanford Chronic Disease
Self-Management Programme to evaluate patient's self-management
outcomes (health status and self-efficacy), at four time points
over a 12-month period, between April 2016 and May 2017. The
patient's drop-out rate was approximately 8%. Data analysis
included descriptive statistics, tests of associations,
correlations and pairwise comparison of outcome variables
between time points, and multivariate regression analysis to
explore factors associated with changes in self-efficacy
following CHBC interventions. The results indicate a reduction
in patient-reported pain, fatigue and illness intrusiveness,
while improvements in general health status and quality of life
were not statistically significant. At baseline, the
self-efficacy mean was 5.91, which dropped to 5.1 after
12\xC2\xA0months. Factors associated with this change included
marital status, education, employment and were
condition-related; whereby self-efficacy for non-HIV and
multimorbid patients was much lower. The odds for self-efficacy
improvement were lower for patients with diagnosed conditions of
longer duration. CHBC programme support, regularity of contact
and proximal location to other services influenced
self-efficacy. Programmes maintaining regular home visits had
higher patient satisfaction levels. Our findings suggest that
there were differential changes in self-management outcomes
following CHBC interventions. While self-management support
through CHBC programmes was evident, CHBC providers require
continuous training, supervision and sustainable funding to
strengthen their contribution. Furthermore, sociodemographic and
condition-related factors should inform the design of future
interventions to optimise outcomes. This study provides a
systematic evaluation of self-management outcomes for a
heterogeneous chronically ill patient population and highlights
the potential and relevant contribution of CHBC programmes in
improving chronic care within sub-Saharan Africa."
cc by-nc (c) Angwenyi, Vibian et al, 2021 http://creativecommons.org/licenses/by-nc/3.0/es/ info:eu-repo/semantics/openAccess
Atenció domiciliària
Malalties cròniques
Home care services
Chronic diseases
An evaluation of self-management outcomes among chronic care
patients in community home-based care programmes in rural
Malawi: A 12-month follow-up study.
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion