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Example Programs (I)
Wheeler (2003) [2] discusses the effects of a self management program entitled Women Take Pride, which greatly improved the QoL of patients and reduced hospital costs far more than the cost of implementing the program. Total savings were estimated at $1800 per patient.
The study consisted of female HF patients over the age of 60
The following benefits were observed in participants of the program:
Less symptomatic
Scored better on the physical dimension of the sickness impact profile
Improved in the 6 minute walk test
Lost more weight
The name Women Take Pride was chosen because PRIDE is an acronym for the 5 main steps in the program
Problem identification
Researching one’s routine
Identifying a management goal
Developing a plan to reach that goal
Expressing one’s reactions and establishing rewards for goal achievement
All program costs were provided for. These included instructional booklets, transportation, videos and self-monitoring tools such as logs and pedometers. The women met once a week to discuss their progress and to pick out areas that they needed to work on, for example exercise or diet. The group sessions were run by a health educator and peer leader.
Example Programs (II)
Harrison, et al. (2002) [3] utilized a self-management system which emphasized outreach from the hospital and in-reach from the community, specifically during the transition stage from hospital to home. Patients participating in the program showed significant improvements in QoL, made fewer subsequent emergency visits and had fewer hospital readmissions.
As you’ve learned by now, men and women deal with HF and its subsequent symptoms in different ways. A symptom which devastates a male, may seem as only a minor inconvenience to a female. When designing a self-management program for your patients, make sure you tailor the program to their specific needs.
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2. Wheeler JRC. Can a disease self-management program reduce health care costs? The case of older women with heart disease. Medical Care. 2003;41(6):706-715.
3. Harrison MB, Browne GB, Roberts J, Tugwell P, Gafni A, Graham ID. Quality of Life of Individuals With Heart Failure. A Randomized Trial of the Effectiveness of Two Models of Hospital-to-Home Transition. Medical Care. 2002;40(4):271-282.
