Impact of an occupation-based self-management programme on chronic disease management

There is a need for the development and evaluation of occupational therapy interventions enabling participation and contributing to self-management for individuals with multiple chronic conditions. This pilot study aimed to assess the feasibility and potential impact of an occupation-based self-management programme for community living individuals with multiple chronic conditions.

Sixteen participants completed a six-week programme. Assessments were conducted at baseline, immediately post-intervention and at eight-week follow-up. Sixteen participants provided immediate follow-up data and 15 participants provided eight-week follow-up data. Outcome measures included participation in occupations; perceptions of occupational performance and satisfaction; self-efficacy; depression, anxiety and quality of life. Focus groups explored participants' perceptions of the programme.

The findings are promising and indicate that the programme delivery was feasible. Significant differences were found immediately post-intervention in frequency of activity participation (P = 0.008), including domestic (P = 0.040) and work/leisure activities (P = 0.015), self-perceptions of occupational performance (P = 0.017) and satisfaction with same (P = 0.023). At eight-week follow-up, significant differences continued to be found in frequency of activity participation (P = 0.018), including work/leisure activities (P = 0.038), perceptions of occupational performance (P = 0.010) and satisfaction (P = 0.008) and self-efficacy (P = 0.050). No differences were found in anxiety, depression or quality of life at follow-up periods. Focus group data supported the programme's impact on activity participation and self-efficacy.

Despite the small sample in this pilot study there were significant improvements in occupational performance and the findings provide support for the programme. However, there is a need to test the intervention rigorously with a definitive randomised trial in a primary care setting.