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dc.creatorAngwenyi, Vibian.
dc.creatorBunders-Aelen, Joske.
dc.creatorCriel, Bart.
dc.creatorLazarus, Jeffrey V.
dc.creatorAantjes, Carolien Jeanette.
dc.date.accessioned2022-06-18T04:45:51Z
dc.date.available2022-06-18T04:45:51Z
dc.date.created2021
dc.date.issued2021
dc.identifier.citationAngwenyi, V., Bunders-Aelen, J., Criel, B., Lazarus, J. V., & Aantjes, C. (2021). 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. Health & Social Care in the Community, 29(2), 353–368. https://doi.org/10.1111/hsc.13094.en_US
dc.identifier.uri10.1111/hsc.13094.en_US
dc.identifier.urihttps://researchspace.ukzn.ac.za/handle/10413/20515
dc.descriptionHEARD, 2021.en_US
dc.description.abstractThis 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 months. 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.en_US
dc.language.isoenen_US
dc.publisherWILEY.en_US
dc.subject.otherCommunity home-based care.en_US
dc.subject.otherHIV--Malaw.en_US
dc.subject.otherNon-communicable diseases.en_US
dc.subject.otherPatient self-management.en_US
dc.subject.otherSelf-efficacy, survey.en_US
dc.titleAn evaluation of self-management outcomes among chronic care patients in community home-based care programmes in rural Malawi: a 12-month follow-up study.en_US
dc.typeArticleen_US


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