Medical care for Long-term health conditions related to chronic disease usually were given to patients with incurable and chronic diseases, hence a self-management that focused on patient adherence towards medical regimens and behavioral changes is critical to improve health outcomes and quality of life [2]. World health organization (WHO) stated that the increasing number of chronic diseases will continue until 2050 where chronic diseases such as cardiovascular diseases, cancer, diabetes and respiratory diseases will increase to 86% of the 90 million deaths every year [3]. Self-management refers to the process of education and support provided to people with chronic health conditions and their families to help them understand their central role in managing their illness, to make decisions about treatment, and to engage in healthy bevioars [4]. For this reason, it is important for patients with chronic diseases to improve their self-management.

Self-management care for chronic disease usually composed of medication management, self-monitoring, and self-awareness, apart from that self-management also requires older adults to manage the emotional consequences of having multiple comorbidities and the benefits of self-management for adults are to reduced dependence on the health system, increased quality of life, individual empowerment, and burder reduction associated with chronic illness [5]. Therefore, self-management can help in the healing process of chronic diseases.      

Research Design

This research uses a scoping review approach to identify self-management in patients with chronic disease. The process of this scoping review begins by searching for articles related to the mesh term such as ("self-management"(MeSH Terms) OR "self-management"(All Fields) OR ("self"(All Fields) AND "management"(All Fields)) OR "self-management"(All Fields)) AND ("chronic disease"(MeSH Terms) OR ("chronic"(All Fields) AND "disease"(All Fields)) OR "chronic disease"(All Fields) OR ("chronic"(All Fields) AND "diseases"(All Fields)) OR "chronic diseases"(All Fields)) AND ("adult"(MeSH Terms)) OR "adult"(All Fields) OR "adults"(All Fields) OR "adult s"(All Fields)). The inclusion criteria are:

Figure 1: Selection of Studies: PRISMA (Preferred Reporting Items For Systematic Reviews And Meta-Analyses) Flowchart

• Articles from 2019 to 2023 

• Randomized control trials, cross sectional and qualitative study 

• Articles retrieved from Pubmed, Science direct, CINAHL, and EBSCHO 

• Respondents/research particpants in the adult category

The following is a flowchart that shows how articles were selected to be included in the analysis.

The Table below describes a detailed content analysis of eight articles that discussed self-management in patients with chronic diseases [1,4,6-10].

The result of content analysis shows that there are eight selected articles, the authors identified five randomized controlled trial (RCT) articles, one qualitative descriptive, one cross-sectional, and one phenomenological descriptive article. These eight articles also discussed the effect of self-management towards the condition of patients with chronic diseases [1,4,6-9,11].

Table 1: Analisis Konten Artikel Terpilih

In this scoping review, there are five articles related to the theme of self-management in patients with chronic diseases with randomized controlled trials [4,6-8,11] one qualitative descriptive study [9] one with cross-sectional study, and one phenomenological descriptive study [1]. The samples of these eight articles ranges from 30 to 4,761 adults in RCT, 45 participants from the descriptive qualitative, 10 participants in the phenomonologicl descriptive, and 108 partisipants in cross sectional study.

In this selected articles, data collection was carried out by collecting respondents in primary health care facilities [4,6,8] the mobile phones application, and self-management education and support (SMES) advertising services programs [7,11] and by in-depth interviews regarding life experiences in self-management [1,9].

The result of this analysis determined that there is a contradictory result in regards of how self-management can assist in the process of treating chronic diseases [1,7-9,11]. This is supported by several studies which state that public health promotion activities must focus on the physical functioning of adults to the elderly who have chronic illnesses so as to assist self-management and be active in community activities in society that can improve physical fitness and quality of life [12]. Self-management interventions specifically to improve pain management, depressive symptoms, incontinence, fall [13]. Hence, it can be concluded that good self-management can increase activity in social life even through during chronic disease treatment.

In addition, repeated self-management training in patients with chronic diseases shows significant improvement in self-management behavior (adherence in medical care), mental health status, behavioral self-efficacy and quality of life [14]. Self-efficacy is positively related to adherence to self-management in patients with chronic diseases [15]. Several articles also shows that interventions such as information technology and face-to-face session can improve the quality of life among patients with chronic diseases [16].  Therefore, self-management can be supported by providing training and information related to managing chronic diseases independently to improve quality of life.

A study stated that there is a low utilization of self-management among older patients with chronic diseases and only a few of the use smart health care devices; self-efficacy has a role in health care and self-management in chronic disase patients [17]. In this regard, patients who are elderly and undergoing chronic diseases treatment need to be assisted by their families so that it is hoped that the self-management of these patients can improve.

The prevalence of chronic diseases have increased in the past few decades, and many elderly have more than one chronic diseases [18]. The conclusion obtained is that self-management can increase independence and also quality of life in adult patients with chronic diseases. For this reason, it is important to improve self-management among adults undergoing chronic disease treatment in order to improve quality of life and self-efficacy as well.

1. Duman, J.G. "Self-Management of Chronic Diseases: A Descriptive Phenomenological Study." Social Work in Public Health, 2020, pp. 300-310. https://doi.org/10.10 80/19371918.2020.1859034.

2. Allegrante, J.  et al. "Interventions to Support Behavioral Self-Management of Chronic Diseases." Annual Review of Public Health, 2019. https://doi.org/10.1146/annurev-publhealth-040218-044008.

3. United Nations. "Chronic Diseases Taking ‘Immense and Increasing Toll on Lives’, Warns WHO." UN News, 19 May 2023. https://news.un.org/en/story/2023/05/1136832.

4. Hessler, D. et al. "Self-Management Support for Chronic Disease in Primary Care: Frequency of Patient Self-Management Problems and Patient Reported Priorities, and Alignment with Ultimate Behavior Goal Selection." BMC Primary Care, 2019, ClinicalTrials.gov ID: NCT01945918.

5. Byrne, G.  et al. "Self-Management Support for Older Adults with Chronic Illness: Implications for Nursing Practice." British Journal of Nursing, 2022. doi:10.12968/bjon.2022 .31.2.86.

6. Khunti, K. et al. "Promoting Physical Activity with Self-Management Support for Those with Multimorbidity: A Randomised Controlled Trial." British Journal of General Practice, 2021. https://doi.org/10.3399/BJGP.2021.0172.

7. Ownby, R. et al. "A Mobile App for Chronic Disease Self-Management for Individuals with Low Health Literacy: A Multisite Randomized Controlled Clinical Trial." MedRxiv, 2023. https://doi.org/10.1101/2023.04.01.23288020.

8. Lear, S. et al. "Assessment of an Interactive Digital Health–Based Self-Management Program to Reduce Hospitalizations Among Patients with Multiple Chronic Diseases." JAMA Network Open, 2021. doi:10.1001/jaman etworkopen.2021.40591.

9. Yous, M. et al. "Older Adults' Experiences and Perceived Impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for Diabetes Self-Management in Canada: A Qualitative Descriptive Study." BMJ Open, 2022. doi:10.1136/bmjop en-2022-068694.

10. Han, T.C. et al. "Association Between Chronic Disease Self-Management, Health Status, and Quality of Life in Older Taiwanese Adults with Chronic Illnesses." Healthcare, 2022. doi:10.3390/healthcare10040609.

11. Campbell, D. et al. "Self-Management Support Using Advertising Principles for Older Adults With Low Income at High Cardiovascular Risk: A Randomized Controlled Trial." Circulation AHA, 2023. https://doi.org/10.1161/C IRCULATIONAHA.123.064189.

12. Li, P.S. et al. "A Study of Physical Activity, Frailty, and Health-Related Quality of Life Among Community-Dwelling Older Adults in Taiwan." The Journal of Nursing Research, 2020. doi:10.1097/JNR.0000000000000402.

13. Taylor, J. et al. "Achieving Self-Management Goals Among Low Income Older Adults with Functional Limitations." Geriatric Nurse, 2019. doi:10.1016/j.gerinurse.2019.01.00 3.

14. Pungchompoo, W. et al. "Effectiveness of a Self-Management Retraining Program Improving the Quality of Life of People Receiving Continuous Ambulatory Peritoneal Dialysis." Nursing & Health Sciences, 2019. doi:10.1111/nhs.12672.

15. Chen, J. et al. "Relationship Between Self-Efficacy and Adherence to Self-Management and Medication Among Patients with Chronic Diseases in China: A Multicentre Cross-Sectional Study." Journal of Psychosomatic Research, 2023. doi:10.1016/j.jpsychores.2022.111105.

16. Zwane, J. et al. "Self-Management of Diabetes and Associated Factors Among Patients Seeking Chronic Care in Tshwane, South Africa: A Facility-Based Study." International Journal of Environmental Research and Public Health, 2023. doi:10.3390/ijerph20105887.

17. Wu, Y. et al. "Associations Between E-Health Literacy and Chronic Disease Self-Management in Older Chinese Patients with Chronic Non-Communicable Diseases: A Mediation Analysis." BMC Public Health, 2022. https://doi. org/10.1186/s12889-022-14695-4.

18. Lorig, Kate. et al. "Chronic Disease Self-Management: A Model for Tertiary Prevention." Sage Journals, 2019. https://doi.org/10.1177/0002764296039006005.

19. Byrne, G. et al. "Self-Management Support for Older Adults with Chronic Illness: Implications for Nursing Practice." British Journal of Nursing, 27 Jan. 2022. https://www. britishjournalofnursing.com/content/professional/self-m anagement-support-for-older-adults-with-chronic-illness -implications-for-nursing-practice/.

20. Klinedinst, T.C. et al. "A Pilot, Randomized, Feasibility Study to Improve Health Self-Management Behaviors in Older Adults with Multiple Chronic Conditions and Functional Limitations: Protocol for the Behavioral Activation and Occupational Therapy Trial (BA+OT)." Journal of Multimorbidity and Comorbidity, 2023. doi:10.11 77/26335565231163037.

21. Lukman, N.A. et al. "Self-Care Experiences of Adults with Chronic Disease in Indonesia: An Integrative Review." International Journal of Chronic Diseases, 2020. doi:10.11 55/2020/1379547.