Table 2 Summary of selected articles
From: Defining an enabling environment for those with chronic disease: an integrative review
Author Year | Type | Purpose of the article | Main results concerning the enabling environment |
|---|---|---|---|
Angwenyi 2019 [24] | Mixed-method study: interviews, focus group, observations (n = 140) | To show that support for Self-management in disadvantaged settings contributes to Empowerment | *Professional/patient interaction: time, supportive environment *Explain prevention approaches, encourage *Home visits appreciated *Learning achieved: 50% through network (religious leader, community and civil society organization, volunteer), radio and television *Peer support *Group problem-solving approaches and a supportive Collective problem-solving approaches and a supportive environment to cope with the stress of the disease |
Brady 2017 [25] | Qualitative study: semi-structured interviews (n = 21) | Showing the use of the internet as a form of Empowerment | *Access to online health information: Confidence, routine questions related to illness, no questions related to acute side of symptoms. *Allows interaction with health professionals to make decisions *Communicate with others with same disease *Interactions with peers provide support *Supportive reciprocal relationship versus patient passive with specialized care *Online community |
Bravo 2015 [12] | Mixed: Scoping review and semi-structured interviews (n = 19) | Develop a conceptual map of empowerment including relationships with health literacy, self-management and shared decision making | *Empowerment level is modifiable by care interventions implemented by professionals and the care system *Health education is necessary but not sufficient for empowerment *Self-management: realistic and personally meaningful goals *Partnership between professionals and patients: informed decision making |
Chang 2015 [26] | Descriptive study via questionnaire (n = 306) | Identify factors of self-care behavior in elderly patients with hypertension | 4 predictors of self-care: *empowerment *social support *depression *perceived severity of illness where to evaluate these variables to support people |
Chow2014 [27] | Randomized controlled trial (n = 312) | To examine the effects of a nurse case management program for older adults with comorbidities at hospital discharge | For effective care interventions must incorporate: *a comprehensive discharge needs assessment *support for patient-centered processes *shared decision making Empowerment interventions increase self-efficacy and decrease hospitalizations Home visits allow interventions in the person’s environment *It is the relationship between the nurse and the patient and not the platform that allows for improvements *Importance of setting up an RPN rather than a generalist because of the different approach |
Cojocaru 2014 [28] | Congress | To show the importance of developing Self-Management in people with chronic diseases | *Professionals consider self-management around structured education *For the patient: complex, multifaceted and non-linear process Patient engagement in self-management depends on: disease type, time, gender, age, socioeconomic status, self-efficacy and social support network *Self-management: major issue for positive health outcomes and costs *Importance of the physician-patient relationship configuration |
Cooper 2019 [29] | Expert opinion | Show how Self-Management and education can support Empowerment | 5 points for self-management: *collaborative care *self-responsibility *focus on individual situations *structured support *liaison with community agencies Importance of time between professional and patient |
Cortez 2017 [30] | Randomized controlled trial (n = 238) | Evaluating the effectiveness of an Empowerment program for metabolic control in patients with diabetes | *Positive metabolic results after implementation of the empowerment program *program based on individualized objectives: psychosocial, behavioural and clinical aspects |
Delaney 2019 [31] | Qualitative phenomenological study (n = 15) | Explore and describe the lived experience of chronically ill adults receiving nurse coaching | *Being listened to and heard increases the patient’s power and sense of empowerment *environment of safety, trust, empowerment *examine the patient experience *interaction between professional and patient *need for guidance in the care system |
Elissen 2013 [32] | Qualitative study in 13 European countries | To show whether Self-Management support is integrated into care approaches | Self-management: key behaviour in chronic disease for effective management, *similarity between countries: nursing, care setting *difference: mode and format of support *Support activities: medical and behavioural management of patients, less emotional management and consequences of illness *support for self-management focused on individual needs: provider time and resources *nature of patient-physician communication and interprofessional work |
Fisher 2017 [33] | Expert opinion | Provide a practical framework for organizing and structuring empowerment programs to improve their use | *building the relationship with the professional * productive interview focused on patients’ needs: competence, autonomy, relationship - patients’ motivations and preferences * respect for patients’ needs |
Fotokian 2017 [34] | Qualitative grounded theory study with interviews and field notes (n = 24) | Illuminating the Empowerment experiences of patients, their families and caregivers | *importance of families in the management of the disease *cooperation with professionals *various sources of information: internet, radio, peers, discussion with professionals |
Hellings 2017 [35] | Expert opinion | Respond to various commissions on prevention and self-management in the context of respiratory diseases | *Mobile application for Education and Self-management *implementation of prevention strategy |
Hernandez 2012 [36] | Quantitative study via questionnaires (n = 378) | Evaluating the effect of Empowerment on adherence and self-care behavior in Diabetes | *Knowledge is not enough to produce self care * patient adherence *psychosocial support *giving the patient an active and central role in care |
Hoffman 2013 [37] | Expert opinion | Describe through examples how nurses apply symptom self-management theory to patients’ perceived self-efficacy | *5 skills for self-management: problem solving, decision making, resource utilization, professional and patient partnership, actions to manage health status * Idea of control, empowerment and confidence |
Isaksson. 2015 [38] | Quantitative study via questionnaires (n = 159) | Describe the perceptions and associations between Empowerment, Self-Management and support needs in a rural community | *Need for professional support at the beginning of the disease and 15 years after *need for emotional support and family support * cultural influence *notion of visibility of the disease, if invisible difficult to ask for help *purpose of self-management: quality of life and well-being |
Johnsen 2017 [39] | Qualitative study via interview (n = 16) | Determine how the concept of Empowerment manifests itself in the cancer patient | *Mastery of treatment and care (ability to say no) *knowledge and skills *care system responsive to people’s concerns and needs no clear link between empowerment and self-care (some patients do not want self-care) |
Kärner Köhler 2018 [40] | Cross-sectional quantitative study (n = 157) | Exploring the relationship between empowerment, self-efficacy and well-being | *Importance of individualized follow-up by focusing on patients’ beliefs, needs and goals *Collaboration between patients and professionals by helping to raise awareness of patient needs, goals and patient’s needs, goals and beliefs *communication between professionals and patients *use of resources to solve problems |
Korpershoek 2016 [41] | Qualitative study with semi-structured interviews (n = 15) | Identify and explain the underlying process of self-management behavior during disease aggravation | *Interventions corresponding to patients’ perceptions, abilities, needs and requests for care * 2 skills for self-management (recognition of worsening and taking action) |
Kristjansdottir 2018 [42] | Qualitative study via interview (n = 39) | Explore patients’ talk about their strengths for their health and well-being | *relation and support of professionals *supporting the forces for self-management and wellbeing. *self-management: priorities, stress reduction, goal setting, knowledge and support *environment for a healthy lifestyle |
Magnezi 2014 [43] | Quantitative study via questionnaires (n = 296) | Evaluating the effects of participation in an online social health network | *greater impact on younger people (20–29 years) *information role *notion of immediate results, information without waiting for a medical consultation *personal questions are easier to ask on the personal questions are easier to ask on the network than to peers |
Musacchio 2011 [44] | Quantitative study using medical record data (n = 1004) | Document the impact of an empowerment program on clinical outcomes, including reducing visits to a diabetologist | *the importance of a multi-professional team in the in the care, role in the follow-up *telemedicine (internet and telephone) generates interaction between patient and doctor, immediate response *social network, email, text message: immediate feedback without waiting for the consultation |
Nie 2016 [45] | Expert opinion | Examine the characteristics and types of health information in diabetes mobile apps in the context of self-management | *applications are related to education (75%) in diabetes and then blood glucose monitoring, diet and exercise *few applications on psychosocial support *research on applications must take into account cultural aspects |
Prigge 2015 [46] | Cross-sectional quantitative study (n = 1622) | Document the benefits and best practices that should guide Empowerment | *need for competence versus need for autonomy vary according to the situation, in severe conditions competence is more effective for empowerment * patient-centered medicine, focused on the patient’s needs and fears *strategies for interaction between doctor and patient *reliable and formal knowledge platform |
Ramsay 2012 [47] | Qualitative study via interview (n = 29) | To study the understanding, acceptance and use of the concept of Empowerment in a low-income clinic | *empowerment perceived as responsibility *passive role of the patient because professional gives instruction for self-management and patient is responsible for implementation *empowerment refers to “doing what the patient is supposed to do *professionals need to elicit questions, explain choices rather than recommend therapy *need to listen, to have patients’ concerns addressed |
Santos 2017 [48] | Quantitative randomized controlled trial (n = 238) | Compare adherence and Empowerment for self-care and glycemic control practices in group education and home visit strategies | *Group education and home visits promote change for adherence and empowerment by providing an important environment (notion of time), more effective with the group *allows for the development of caregiving skills such as decision making, autonomy and the experience of living with the disease *Role of peers, exchange of experience |
Schildmeuer 2018 [49] | Expert opinion | Conduct a review of the development of an online health tool to empower patients | *social support from the moment of diagnosis *peers patients forum for experiences, (autonomy, skills and relationship) *ehealth: provide functionalities for self-management. *connecting with peers, relatives |
Stoilkava Hartmann 2018 [50] | Theory | Present a care model: KALMOD | *holistic approach to optimize self-management *importance of communication *education practice adapted to each patient |
Storni 2013 [51] | Case study via observations and interviews (n = 14) | Question the design of a self-care technology that supports a large number of patients | *understanding the home environment for the realization of assistive technology *understanding the place and role of each *Glycemic device refers to medical monitoring but does not address the complexity and uncertainty of patients *appropriate the technology by adapting it to patients’ conditions |
Suarez Vazquez 2016 [52] | Quantitative study via questionnaires (n = 181) | Analyze the Empowerment experience of patients | *Importance of involvement in empowerment - trust in health care professionals *the more serious the illness, the less involved the patient is *climate of trust generates a positive self-perception of empowerment |
Sürücü 2018 [53] | Quantitative descriptive cross-sectional study (n = 220) | Studying Empowerment, social support as a factor in self-care behaviour | * Perception of social support has an impact on self-care behaviour *feeling empowered allows for self-management of the disease *training related to behavioural approaches and culture |
Tang 2010 [54] | Quantitative study of a cohort (n = 77) | Measure the impact of an intervention in diabetes management | *Importance of a continuous intervention, centered on the patient, evolving in relation to the environment and in real life conditions *patient choice of behaviour change leads to greater motivation *clinical feedback *newsletter for self-care behaviour |
Vadiee 2012 [55] | Expert opinion | Acquire skills with a patient program | *Patient expertise is a central element *Self-care: an element of chronic disease management for the maintenance of optimum health *Self-care: essential basis for preventive and effective measures |
Varekamp 2009 [56] | Qualitative exploratory study with interview (n = 64) | Exploring Empowerment in Employees with Chronic Illness | *empowerment training: working on work-related issues and seeking solutions in management *importance of communication here to ask for accommodations *different focus: not on their limitations but on their skills as professionals *develop knowledge and skills * focus on needs |
Varekamp 2011 [57] | Randomized controlled quantitative study (n = 64) | Evaluate the effect of a program on employee stress and fatigue | * self-efficacy increases if empowerment *interventions focused on employees’ needs |
Vosbergen 2013 [58] | Qualitative study via interviews and focus group (n = 23) | Examining the patient experience with Self-Management at different stages of coronary artery disease | *Healthcare professionals remain the preferred source of information *notion of time with the health care professional *online self-management service: tailored to needs * need for psychological support to reduce anxiety and stress |
Wong 2012 [59] | Quantitative cohort study (n = 1141) | Evaluating the effectiveness of an Empowerment program | *importance of time spent on education *chronic disease management: medical, social and emotional needs |
Wong 2016 [56] | Quantitative cohort study (n = 24,250) | Evaluating the effectiveness of an Empowerment program on the use of hospital services and care | *Program influence: behaviour change, healthy living *program structures education, decreases frequency of care and hospitalization |
Zamanzadeh.2016 [60] | Randomized controlled quantitative study (n = 66) | Studying the effect of telephone-based distance learning on Empowerment | *Telehealth program provides structured care: improves relationship, removes barriers of location and time *importance of time spent on education *distance education has a positive effect |
Zhang 2019 [61] | Prospective quantitative study (n = 60) | Evaluating the effect of health education on patients’ quality of life using empowerment theory | *better understanding of the disease allows the patient to develop self-management and quality of life *health education allows the patient to feel in control of his life and his disease *health education is necessary if there is no empowerment in relation to the disease |