{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:41:05Z","timestamp":1789522865603,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dr. Ian and Shirley Rowe Research Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Self-management is advocated as a feasible, effective intervention to support individuals to actively manage the impact of illness and live healthier lives. We sought to evaluate a piloted self-management model, SET for Health, tailored for individuals living with schizophrenia embedded within ambulatory case management. (2) Methods: A mixed-methods design engaged 40 adults living with schizophrenia in the SET for Health protocol. Functional and symptomatic outcomes were measured by self-report and clinician ratings at baseline and completion of self-management plans, on average one year later. Semi-structured qualitative client interviews invited evaluations of personal experiences with the intervention. (3) Results: Significant improvements were found concerning client illness severity, social and occupational functioning, illness management and functional recovery with reductions in emergency visits and days in hospital. Clients endorsed the value of the intervention. Baseline clinical characteristics did not predict who benefited. Participation contributed to motivational gains and quality of life. (4) Conclusions: Results confirmed self-management support embedded within traditional case management improved clients\u2019 clinical and functional status, and contributed to quality of life. Clients engaged in their recovery and actively used self-management strategies. Self-management can be successfully adopted by clients with schizophrenia regardless of age, gender, education, illness severity or duration.<\/jats:p>","DOI":"10.3390\/ijerph20043035","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:33:27Z","timestamp":1675996407000},"page":"3035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Participants\u2019 Evaluation and Outcomes following Integration of Self-Management Support into Outpatient Schizophrenia Case Management"],"prefix":"10.3390","volume":"20","author":[{"given":"Heather E.","family":"McNeely","sequence":"first","affiliation":[{"name":"Schizophrenia and Community Integration Service, St. Joseph\u2019s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada"},{"name":"Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8N 3K7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4770-8797","authenticated-orcid":false,"given":"Lori","family":"Letts","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary-Lou","family":"Martin","sequence":"additional","affiliation":[{"name":"Forensic Service, St. Joseph\u2019s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada"},{"name":"School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Strong","sequence":"additional","affiliation":[{"name":"Schizophrenia and Community Integration Service, St. Joseph\u2019s Healthcare Hamilton, Hamilton, ON L8N 4A6, Canada"},{"name":"School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","unstructured":"Ministry of Health and Long-Term Care (2022, September 23). Preventing and Managing Chronic Disease: Ontario\u2019s Framework, Available online: https:\/\/www.health.gov.on.ca\/en\/pro\/programs\/cdpm\/pdf\/framework_full.pdf."},{"key":"ref_2","unstructured":"De Silva, D. (2022, September 23). Evidence: Helping People to Help Themselves. Available online: https:\/\/www.health.org.uk\/sites\/default\/files\/HelpingPeopleHelpThemselves.pdf."},{"key":"ref_3","unstructured":"Pearson, M.L., Mattke, S., Shaw, R., Ridgely, M.S., and Wiseman, S.H. (2007). Patient Self-Management Support Programs: An Evaluation, Agency for Healthcare Research and Quality. AHRQ Publication No. 08-0011; EP-200711-29."},{"key":"ref_4","unstructured":"Health Quality Ontario (2019, September 06). Quality Standards. Schizophrenia: Care in the Community for Adults. Quality Statement 3. Available online: https:\/\/www.hqontario.ca\/Evidence-to-Improve-Care\/Quality-Standards\/View-all-Quality-Standards\/Schizophrenia-Care-in-the-Community."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/jep.13728","article-title":"Preparing an Integrated self-management support intervention for people living with schizophrenia: Creating collaborative spaces","volume":"29","author":"Strong","year":"2022","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/jep.13723","article-title":"Organisational change to integrate self-management into specialised mental health services: Creating collaborative spaces","volume":"29","author":"Strong","year":"2022","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1093\/schbul\/sbr030","article-title":"Age of onset of schizophrenia: Perspectives from structural neuroimaging studies","volume":"37","author":"Gogtay","year":"2011","journal-title":"Schizophr. Bull."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s11136-016-1368-5","article-title":"Measuring chronic condition self-management in an Australian community: Factor structure of the revised Partners in Health (PIH) scale","volume":"26","author":"Smith","year":"2017","journal-title":"Qual. Life Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1177\/0004867416641195","article-title":"Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders","volume":"50","author":"Galletly","year":"2016","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_10","unstructured":"Mental Health Commission of Canada (2012). Changing Directions, Changing Lives: The Mental Health Strategy for Canada, The Commission."},{"key":"ref_11","unstructured":"Mental Health Commission of Canada (2021, November 30). Guidelines for Recovery-Oriented Practice. Available online: https:\/\/www.mentalhealthcommission.ca."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1192\/bjp.2019.54","article-title":"Self-management interventions for people with severe mental illness: Systematic review and meta-analysis","volume":"214","author":"Lean","year":"2019","journal-title":"Br. J. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1111\/j.1447-0349.2012.00863.x","article-title":"Self-management education interventions for persons with schizophrenia: A meta-analysis","volume":"22","author":"Zou","year":"2013","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_14","unstructured":"Bodenheimer, T., MacGregor, K., and Sharifi, C. (2005). Helping Patients Manage Their Chronic Conditions, California HealthCare Foundation. Available online: http:\/\/www.chef.org\/programs."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Thabane, L., Ma, J., Chu, R., Cheng, J., Ismaila, A., Rios, L.P., Robson, R., Thabane, M., Giangregorio, L., and Goldsmith, C.H. (2010). A tutorial on pilot studies: The what, why and how. BMC Med. Res. Methodol., 10.","DOI":"10.1186\/1471-2288-10-1"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Roosenschoon, B.-J., van Weeghel, J., Bogaards, M., Deen, M.L., and Mulder, C.L. (2016). Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial. BMC Psychiatry, 16.","DOI":"10.1186\/s12888-016-1096-y"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2316","DOI":"10.3389\/fpsyt.2021.723435","article-title":"Effects of Illness Management and Recovery: A Multicenter Randomized Controlled Trial","volume":"12","author":"Roosenschoon","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_18","first-page":"32","article-title":"Illness Management and Recovery (IMR) Scales","volume":"Volume II","author":"Mueser","year":"2005","journal-title":"Measuring the Promise: A Compendium of Recovery Measures"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s10597-007-9087-6","article-title":"Measuring Illness Management Outcomes: A Psychometric Study of Clinician and Consumer Rating Scales for Illness Self Management and Recovery","volume":"43","author":"Salyers","year":"2007","journal-title":"Community Ment. Health J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/0277-9536(93)90033-Z","article-title":"The structure and properties of the Sense of Coherence Scale","volume":"36","author":"Antonovsky","year":"1993","journal-title":"Soc. Sci. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1111\/j.1475-6773.2005.00438.x","article-title":"Development and Testing of a Short Form of the Patient Activation Measure","volume":"40","author":"Hibbard","year":"2005","journal-title":"Health Serv. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s10488-009-0239-6","article-title":"Development of the Patient Activation Measure for Mental Health","volume":"37","author":"Green","year":"2010","journal-title":"Adm. Policy Ment. Health Ment. Health Serv. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1016\/j.psychres.2015.05.100","article-title":"The relationship between hope and patient activation in consumers with schizophrenia: Results from longitudinal analyses","volume":"228","author":"Oles","year":"2015","journal-title":"Psychiatry Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.psychres.2011.12.052","article-title":"Validation of the Integrative Hope Scale in people with psychosis","volume":"198","author":"Schrank","year":"2012","journal-title":"Psychiatry Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/j.1365-2850.2011.01767.x","article-title":"Factors associated with good self-management in older adults with a schizophrenic disorder compared with older adults with physical illnesses","volume":"19","author":"Gallagher","year":"2012","journal-title":"J. Psychiatr. Ment. Health Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00005650-199901000-00003","article-title":"Evidence suggesting that a chronic disease self-management progam can improve health status while reducing hospitalization: A randomized trial","volume":"37","author":"Lorig","year":"1999","journal-title":"Med. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1111\/j.1475-6773.2005.00404.x","article-title":"Predicting Mortality and Healthcare Utilization with a Single Question","volume":"40","author":"DeSalvo","year":"2005","journal-title":"Health Serv. Res."},{"key":"ref_28","first-page":"321","article-title":"Quality of Life Enjoyment and Satisfaction Questionnaire: A new measure","volume":"29","author":"Endicott","year":"1993","journal-title":"Psychopharmacol. Bull."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1007\/s11136-005-2816-9","article-title":"Validity of an abbreviated Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-18) for schizophrenia, schizoaffective, and mood disorder patients","volume":"14","author":"Ritsner","year":"2005","journal-title":"Qual. Life Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1600-0447.2000.tb10933.x","article-title":"Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social funtioning","volume":"101","author":"Morosini","year":"2000","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_31","first-page":"28","article-title":"The Clinical Global Impressions Scale: Applying a Research Tool in Clinical Practice","volume":"4","author":"Busner","year":"2007","journal-title":"Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/nhs.12048","article-title":"Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study","volume":"15","author":"Vaismoradi","year":"2013","journal-title":"Nurs. Health Sci."},{"key":"ref_33","first-page":"3","article-title":"Chapter 1: Primary care research: A multimethod typology and qualitative road map","volume":"Volume 3","author":"Crabtree","year":"1992","journal-title":"Doing Qualitative Research. Research Methods for Primary Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/bmj.b49","article-title":"Patient and public involvement in chronic illness: Beyond the expert patient","volume":"338","author":"Greenhalgh","year":"2009","journal-title":"Br Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/1049732304272048","article-title":"Uncovering the Limits of Patient-Centeredness: Implementing a Self-Management Trial for Chronic Illness","volume":"15","author":"Rogers","year":"2005","journal-title":"Qual. Health Res."},{"key":"ref_36","first-page":"CD010523","article-title":"Personalised care planning for adults with chronic or long-term health conditions","volume":"3","author":"Coulter","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/NMD.0b013e318288e253","article-title":"Levels of Patient Activation Among Adults With Schizophrenia: Associations with hope, symptoms, medication adherence, and recovery attitudes","volume":"201","author":"Kukla","year":"2013","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3966","DOI":"10.1111\/jocn.15407","article-title":"Modelling of self-management in schizophrenia: The role of neurocognition, self-efficacy and motivation","volume":"29","author":"Zhou","year":"2020","journal-title":"J. Clin. Nurs."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Erikson, M., Mittelmark, M.B., Sagy, S., Eriksson, M., Bauer, G.F., J\u00fcrgen, M.P., Lindstrom, B., and Espnes, G.A. (2017). The Handbook of Salutogenesis [Internet], Springer.","DOI":"10.1007\/978-3-319-04600-6"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.paid.2016.04.001","article-title":"Through the tunnel, to the light: Why sense of coherence covers and exceeds resilience, optimism, and self-compassion","volume":"98","author":"Grevenstein","year":"2016","journal-title":"Pers. Individ. Differ."},{"key":"ref_41","unstructured":"National Collaborating Centre for Mental Health (2014). Psychosis and Schizophrenia in Adults: Treatment and Management, National Institute for Health and Care Excellence. Available online: https:\/\/www.nice.org.uk\/guidance\/cg178\/evidence\/full-guideline-490603565."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3035\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:28:17Z","timestamp":1760120897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,9]]},"references-count":41,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043035"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043035","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,9]]}}}