Korean J Rehabil Nurs.  2017 Jun;20(1):42-51. 10.7587/kjrehn.2017.42.

Improvement and Backsliding after Chronic-disease Self-management Education in Japan: One-year Cohort Study

  • 1College of Nursing, Konyang University, Daejeon, Korea. mjpark@konyang.ac.kr


In people who have chronic diseases, disabilities, and rehabilitation needs, self-management education can improve health and health-related behavior, and it can reduce the utilization of healthcare services. The purpose of this research was to assess the long-term effects of chronic-disease self-management education in Japan.
This study included 184 adults living with various chronic medical conditions who participated in the Chronic Disease Self-Management Program (CDSMP) in Japan. Data were collected before the program began, and then collected 3 more times over 1 year.
Healthcare-service utilization was low at baseline, and it did not change. Self-evaluated health status, health-related distress, coping with symptoms, communication with doctors, and self-efficacy to manage symptoms all improved after the program. However, there was backsliding in all of the outcomes that had improved.
Some benefits of this program can last for at least 1 year, but interventions to prevent attenuation may be needed. For economic evaluations, research should focus on populations with higher baseline levels healthcare-service utilization, including use of rehabilitation services. Also, more attention should be focused on the longer-term decay or persistence of the program's benefits, particularly regarding on preventing and reducing disabilities and with regard to rehabilitation needs.


Chronic Illness; Self-management; Education of patients; Backsliding; Decay of impact
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