چکیده (انگلیسی):

Background:A rising number of people with chronic conditions is offered interventions to enhance self-management.
The responsiveness of individuals to these interventions depends on patient characteristics. We aimed to
develop and validate a tool to facilitate personalised counselling and support for self-management in patients with
chronic diseases in primary care.
Methods:We drafted a prototype of the tool for Self-Management Screening (SeMaS), comprising 27 questions that
were mainly derived from validated questionnaires. To reach high content validity, we performed a literature review
and held focus groups with patients and healthcare professionals as input for the tool. The characteristics self-efficacy,
locus of control, depression, anxiety, coping, social support, and perceived burden of disease were incorporated into
the tool. Three items were added to guide the type of support or intervention, being computer skills, functioning in
groups, and willingness to perform self-monitoring. Subsequently, the construct and criterion validity of the tool were
investigated in a sample of 204 chronic patients from two primary care practices. Patients filled in the SeMaS and a set
of validated questionnaires for evaluation of SeMaS. The Patient Activation Measure (PAM-13), a generic instrument to
measure patient health activation, was used to test the convergent construct validity.
Results:Patients had a mean age of 66.8 years and 46.6 % was female. 5.9 % did not experience any barrier to
self-management, 28.9 % experienced one minor or major barrier, and 30.4 % two minor or major barriers. Compared
to the criterion measures, the positive predictive value of the SeMaS characteristics ranged from 41.5 to 77.8 % and the
negative predictive value ranged from 53.3 to 99.4 %. Crohnbach’s alpha for internal consistency ranged from 0.56 to
0.87, except for locus of control (α= 0.02). The regression model with PAM-13 as a dependent variable showed that the
SeMaS explained 31.7 % (r
2
= 0.317) of the variance in the PAM-13 score.
Conclusions:SeMaS is a short validated tool that can signal potential barriers for self-management that need to be
addressed in the dialogue with the patient. As such it can be used to facilitate personalised counselling and support to
enhance self-management in patients with chronic conditions in primary care.