Self-management education for rehabilitation inpatients: A cluster-randomized controlled trial

Abstract

Objective: To evaluate generic self-management modules (SelMa) as an adjunct to disease-specific educational programs during inpatient medical rehabilitation.

Methods: A bi-center cluster-randomized controlled trial with 698 patients with coronary artery disease, metabolic syndrome, or inflammatory bowel disease was conducted. We compared two versions of SelMa, a group with 3 h or a lecture with 1 h, respectively, in addition to disease-related patient education, to usual care (only disease-related education). SelMa aims at providing skills that may help implementing health behavior. The primary outcomes were goal setting and behavior planning at discharge and goal attainment and health behavior at 6- and 12-months follow-up. Secondary outcomes included motivation, knowledge and self-management competences.

Results: At discharge, SelMa group, but not SelMa lecture, proved superior to usual care regarding goal setting (p = 0.007, d = 0.26), but not behavior planning (p = 0.37, d = 0.09). Significant effects were also observed on several secondary outcomes. At later follow-up, however, no effects on primary outcomes emerged. Participants' satisfaction was higher in the group than the lecture format.

Conclusions: These short modules did not succeed in improving self-management skills in the long-term.

Practice implications: A self-management group may foster self-management skills in short term. Interventions should be developed to increase sustainability of effects.

Keywords: Chronic diseases; Cluster-RCT; Evaluation; Patient education; Rehabilitation; Self-management.