Haslbeck Jörg, Zanoni Sylvie, Hartung Uwe, Klein Margot, Gabriel Edith, Eicher Manuela, Schulz Peter J
Research Institute of the Kalaidos University of Applied Science Department of Health, Careum Research, Zurich, Switzerland.
Institute of Communication and Health (ICH), Università della Svizzera Italiana, Lugano, Switzerland.
BMC Health Serv Res. 2015 Dec 28;15:576. doi: 10.1186/s12913-015-1251-z.
Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process.
Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G).
Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization.
Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.
斯坦福大学的慢性病自我管理项目（CDSMP）以拥有大量证据基础且在各国广泛传播而脱颖而出。迄今为止，尚无将其系统地适配到德语环境中的证据或实践。本文的目的是描述CDSMP（2010 - 2014年）的德语系统适配与实施过程，报告为瑞士法语区对法裔加拿大CDSMP进行的特定语言适配情况，并报告初始评估过程的结果。
综合运用多种研究方法来探究工作坊参与者的观点，将纵向定量调查与自我报告问卷、定性焦点小组和访谈相结合。对德语和法语适配版本都进行了评估过程，以深入了解参与者在项目中的体验并评估其影响。使用德语版的慢性病自我管理6项自我效能量表（SES6G）来测量感知自我效能。
瑞士和奥地利的35个工作坊中的278人参与了该研究。研究参与者接受项目内容、同伴主导的方法，并认为主要方法有用，但结构化方法并未满足他们所有的需求或期望。参与工作坊后，观察到对自我效能有短期和长期影响（尽管在6个月时略有下降）。参与者报告称在应对和自我护理方面有积极影响，但对医疗服务利用的影响有限。
我们的研究结果表明，跨境适配过程是有效的，并且CDSMP可以在不同的医疗保健和社区环境中成功实施。适配后的CDSMP可被视为中欧德语区和法语区支持自我管理的一项资产。它可能对慢性病护理以及慢性病的一级预防和潜在的三级预防产生有意义、广泛的影响。需要进一步研究以调整该项目，以便更好地惠及最可能从中受益的弱势群体，促进他们在慢性病方面的健康素养。
