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.
| dc.contributor.author | Angwenyi, Vibian. | |
| dc.contributor.author | Bunders-Aelen, Joske. | |
| dc.contributor.author | Criel, Bart. | |
| dc.contributor.author | Lazarus, Jeffrey V. | |
| dc.contributor.author | Aantjes, Carolien Jeanette. | |
| dc.date.accessioned | 2022-06-18T04:45:51Z | |
| dc.date.available | 2022-06-18T04:45:51Z | |
| dc.date.created | 2021 | |
| dc.date.issued | 2021 | |
| dc.description | HEARD, 2021. | en_US |
| dc.description.abstract | 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 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.identifier.citation | Angwenyi, 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.uri | 10.1111/hsc.13094. | en_US |
| dc.identifier.uri | https://researchspace.ukzn.ac.za/handle/10413/20515 | |
| dc.language.iso | en | en_US |
| dc.publisher | WILEY. | en_US |
| dc.subject.other | Community home-based care. | en_US |
| dc.subject.other | HIV--Malaw. | en_US |
| dc.subject.other | Non-communicable diseases. | en_US |
| dc.subject.other | Patient self-management. | en_US |
| dc.subject.other | Self-efficacy, survey. | en_US |
| dc.title | 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. | en_US |
| dc.type | Article | en_US |
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