What we know about the purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: A scoping review
Abstract
Objectives To identify self-report, self-management measures for adults with chronic conditions, and describe their purpose, theoretical foundation, dimensionality (multi versus uni), and scope (generic versus condition specific).Methods A search of four databases (8479 articles) resulted in a scoping review of 28 self-management measures.Results Although authors identified tools as measures of self-management, wide variation in constructs measured, purpose, and theoretical foundations existed. Subscales on 13 multidimensional tools collectively measure domains of self-management relevant to clients, however no one tool's subscales cover all domains.Conclusions Viewing self-management as a complex, multidimensional whole, demonstrated that existing measures assess different, related aspects of self-management. Activities and social roles, though important to patients, are rarely measured. Measures with capacity to quantify and distinguish aspects of self-management may promote tailored patient care.Practice implications In selecting tools for research or assessment, the reason for development, definitions, and theories underpinning the measure should be scrutinized. Our ability to measure self-management must be rigorously mapped to provide comprehensive and system-wide care for clients with chronic conditions. Viewing self-management as a complex whole will help practitioners to understand the patient perspective and their contribution in supporting each individual patient.
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The paucity of intervention programs addressing clients' role management has been highlighted in other reviews, as has the limited focus on finding and managing formal and informal resources.
“The paucity of intervention programs addressing clients’ role management has been highlighted in other reviews [11,75], as has the limited focus on finding and managing formal and informal resources [34].”
From Features of Structured, One-to-One Videoconference Interventions That Actively Engage People in the Management of Their Chronic Conditions: Scoping Review (2025) · cites this paper as [75]
Over 50% of programs had content aligned with the same 4 domains (disease control, healthy behaviors, internal, and process) of the TEDSS framework, findings that mimic those of others using the TEDSS framework.
“Over 50% of the programs (18/25, 72%; disease and control domain: 14/25, 56%; healthy behavior domain: 13/25, 52%; internal domain: 13/25, 52%) had content aligned with the same 4 domains (disease control, healthy behaviors, internal, and process) of the TEDSS framework, findings that mimic those of others using the TEDSS framework to analyze program content and program outcome measures [11,75].”
From Features of Structured, One-to-One Videoconference Interventions That Actively Engage People in the Management of Their Chronic Conditions: Scoping Review (2025) · cites this paper as [75]
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Warner, G., Packer, T. L., Kervin, E., Sibbald, K., & Audulv, Å. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.07.002 · Cited by 38 · see citing works
Self-citationCabezas, M.-F., Nazar, G., Ranchor, A. V., & Annema, C. (2025) · Annals of Behavioral Medicine · doi:10.1093/abm/kaaf073 · Cited by 49 · see citing works
Lawless, M., Tieu, M., Chan, R. J., Hendriks, J., & Kitson, A. A. (2023) · Journal of Applied Gerontology · doi:10.1177/07334648231161929 · Cited by 33 · see citing works
“Like previous studies (e.g., Hudon et al., 2021; Packer et al., 2018), the definitions and theoretical foundations used to develop the instruments included in this review were varied, indicating that the concepts of self-care and self-management require further clarification and refinement.”
BackgroundMethodResultInfluentialGeneric Self-Reported Questionnaires Measuring Self-Management: A Scoping Review
Hudon, É., Hudon, C., Lambert, M., Bisson, M., & Chouinard, M. (2020) · Clinical Nursing Research · doi:10.1177/1054773820974149 · Cited by 30 · see citing works
“Other reviews on selfmanagement highlighted four to six generic questionnaires addressing self-management for adults in various settings but not specific to people with CCs (Matarese et al., 2017; Packer et al., 2017; Sidani, 2011).”
BackgroundChen, Y., Tan, D., Xu, Y., Wang, B., Li, X., Cai, X., Li, M., Tang, C., Wu, Y., Shu, W., et al. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.09.007 · Cited by 30 · see citing works
Coping with diabetes: Provider attributes that influence type 2 diabetes adherence
Freeman-Hildreth, Y., Aron, D. C., Cola, P. A., & Wang, Y. (2019) · PLoS ONE · doi:10.1371/journal.pone.0214713 · Cited by 27 · see citing works
Engelen, M. M., van Dulmen, S., Vermeulen, H., de Laat, E., & van Gaal, B. G. I. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104014 · Cited by 25 · see citing works
Strategies for Patient, Family, and Caregiver Engagement
Bennett, W. L., Pitts, S. I., Aboumatar, H. J., Sharma, R., Smith, B. M., Das, A., Day, J., Holzhauer, K., & Bass, E. B. (2020) · doi:10.23970/ahrqepctb36 · Cited by 19 · see citing works
Healthy aging with HIV: The role of self-management support
Boucher, L. M., O’Brien, K. K., Baxter, L. N., Fitzgerald, M. L., Liddy, C. E., & Kendall, C. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.02.019 · Cited by 18 · see citing works
Kephart, G. C., Packer, T. L., Audulv, Å., & Warner, G. (2018) · Quality of Life Research · doi:10.1007/s11136-018-2036-8 · Cited by 16 · see citing works
Self-citationvan Gaal, B. G. I., Engelen, M. M., Adriaansen, M. J. M., Vermeulen, H., de Laat, E., & van Dulmen, S. (2022) · Journal of Tissue Viability · doi:10.1016/j.jtv.2022.07.002 · Cited by 14 · see citing works
Self-management of geriatric syndromes - an observational study
Prell, T., Wientzek, R., & Schönenberg, A. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04442-8 · Cited by 12 · see citing works
“As stated in the Background section, there is no universally accepted definition of self-management [16, 19].”
BackgroundInfluentialMaria, M. D., Saurini, M., Erba, I., Vellone, E., Riegel, B. J., Ausili, D., & Matarese, M. (2024) · Journal of Clinical Nursing · doi:10.1111/jocn.17397 · Cited by 13 · see citing works
Boucher, L. M., Shoemaker, E. S., Liddy, C. E., Leonard, L. E., MacPherson, P. A., Presseau, J., Martin, A., Pineau, D., Lalonde, C., Diliso, N., et al. (2022) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.1080/17482631.2022.2082111 · Cited by 12 · see citing works
“ing in social activities and roles has been a neglected outcome in self-management research (Packer et al., 2018).”
BackgroundInfluentialBathen, T., Krohg‐Sørensen, K., & Lidal, I. B. (2020) · American Journal of Medical Genetics Part A · doi:10.1002/ajmg.a.61827 · Cited by 12 · see citing works
“Selfmanagement of a disease include having the confidence to deal with medical-, role- and emotional management of a condition (Packer et al., 2018).”
BackgroundKephart, G. C., Packer, T. L., Audulv, Å., Chen, Y.-T., Robinson, A., Olsson, I., & Warner, G. (2022) · Quality of Life Research · doi:10.1007/s11136-022-03165-4 · Cited by 9 · see citing works
“Two scoping reviews of 35 existing self-management measures have identified major deficiencies in existing measures [15, 16].”
BackgroundInfluentialSelf-citationSchönenberg, A., Teschner, U., Prell, T., & Mühlhammer, H. M. (2022) · Healthcare · doi:10.3390/healthcare10091785 · Cited by 9 · see citing works
“Due to this close relation, many questionnaires designed to measure self-management are often based on self-care agency [4].”
BackgroundMethodInfluentialCounselling for patients with a temporomandibular disorder: A scoping review and concept analysis
van der Meer, H. A., van der Wal, A., van Hinte, G., & Speksnijder, C. M. (2024) · Journal of Oral Rehabilitation · doi:10.1111/joor.13827 · Cited by 9 · see citing works
Packer, T. L., Kephart, G. C., Audulv, Å., Keddy, A. C., Warner, G., Peacock, K., & Sampalli, T. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-036776 · Cited by 9 · see citing works
Self-citationThe Development of Self-Management in Young People with Chronic Conditions: A Transitional Process
Sattoe, J. N. T., & van Staa, A. (2021) · Springer eBooks · doi:10.1007/978-3-030-64293-8_3 · Cited by 8 · see citing works
The Profound Implications of the Meaning of Health for Health Care and Health Equity
Fiscella, K. A., & Epstein, R. M. (2023) · Milbank Quarterly · doi:10.1111/1468-0009.12660 · Cited by 9 · see citing works
Alizadeh, N., Packer, T., Chen, Y.-T., & Alnasery, Y. (2023) · Patient Education and Counseling · doi:10.1016/j.pec.2023.107866 · Cited by 8 · see citing works
Self-citationKeddy, A. C., Packer, T. L., Audulv, Å., Sutherland, L., Sampalli, T., Edwards, L., & Kephart, G. C. (2020) · Healthcare Management Forum · doi:10.1177/0840470420942262 · Cited by 7 · see citing works
Self-citationSmith, D., Fairweather‐Schmidt, A. K., Harvey, P. W., Bowden, J. A., Lawn, S., & Battersby, M. (2019) · Journal of Advanced Nursing · doi:10.1111/jan.14124 · Cited by 6 · see citing works
A process and impact evaluation of a peer-led HIV self-management program
Feldman, M. B., Tran, T. T., Boucher, L. M., Abdelqader, F., Raker, A. R., & Hile, S. J. (2022) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2022.102175 · Cited by 6 · see citing works
Use of the Hypertension Self-Care Profile: A Scoping Review
Han, H., Benjasirisan, C., Metlock, F., Tesfai, Y., & Commodore-Mensah, Y. Y. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22081244 · Cited by 4 · see citing works
“Of the 55 full-text articles, three were review papers [14–16], two were study protocols without data [17,18], and two studies used some of the items on the HBP SCP to create a new instrument measuring different concepts such as dietary regulation [19] or knowledge [20].”
Instruments for measuring self-management and self-care in geriatric patients – a scoping review
Wientzek, R., Brückner, R. M., Schönenberg, A., & Prell, T. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1284350 · Cited by 4 · see citing works
Xie, H., Wu, A.-R., Xu, Z., Zhang, Q., Wang, X., Yu, H., Li, N., Wei, Y., Li, X., Zhai, H., et al. (2024) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2024.2391594 · Cited by 4 · see citing works
“A recent scoping review discovered 28 diverse self-management measures, of which 20 were disease-* specific, and 8 were generic (2).”
de Córdova, M. I. P., Albornoz-Jiménez, C. F., Gómez, T. G., Hernández, R. C. L., Malibrán-Luque, D. J., & Díaz, R. (2020) · Journal of Hospital Administration · doi:10.5430/jha.v9n4p20 · Cited by 4 · see citing works
“[16] Also, the complexity of this self-management is a complex, multi-dimensional and changing process.[6, 12] According to these results, the instrument comprises three dimensions: management of the medical condition (items 1, 2, 3, 6, 7, 8), participation dimension within the health system (items 4, 5) and managemen…”
BackgroundLiu, K., Meng, G., Li, C., Wang, S., Fan, X., & Chen, Q. (2026) · Quality of Life Research · doi:10.1007/s11136-026-04163-6 · Cited by 3 · see citing works
“In a scoping review by Packer et al., only 8 of the 28 included instruments were generic measures for chronic diseases, with many relevant instruments overlooked [24].”
InfluentialValidade do Índice de Katz para avaliar a dependência em pacientes em tratamento oncológico
Gallasch, C. H., Vieira, H. W. D., Lucchesi, P. A. D. O., Balbinotti, M. A. A., Rebustini, F., & Ferretti‐Rebustini, R. E. D. L. (2022) · Acta Paulista de Enfermagem · doi:10.37689/acta-ape/2022ao015266 · Cited by 3 · see citing works
“(39) A unidimensionalidade tem se mos-trado como uma boa qualidade do IK, pois ele é de fácil utilização e possui boas evidências de validade, confiabilidade e replicabilidade, como também ob-servado pelos resultados de AFE, AFC e índice G-H neste estudo.”
Olsson, I., Kephart, G. C., Packer, T. L., Björk, S., Isaksson, U., Chen, Y.-T., Nordström, A., & Audulv, Å. (2025) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-025-00892-3 · Cited by 3 · see citing works
“Furthermore, many self-management measures are disease specific; yet self-management interventions are often used across different diagnostic groups, and many people need to manage multi-morbidity [20, 21].”
Self-citationChen, Y.-T., Lehman, M., Van Denend, T., Kish, J., Wu, Y., Preissner, K., Plow, M., & Packer, T. L. (2025) · Journal of Medical Internet Research · doi:10.2196/58543 · Cited by 3 · see citing works
“The paucity of intervention programs addressing clients’ role management has been highlighted in other reviews [11,75], as has the limited focus on finding and managing formal and informal resources [34].”
Self-citationKamaryati, N. P., Malathum, P., Monkong, S., & Satitvipawee, P. (2025) · Pacific Rim International Journal of Nursing Research · doi:10.60099/prijnr.2025.274034 · Cited by 2 · see citing works
Lawless, M., de Plaza, M. A. P., Thamm, C., Kitson, A. A., & Paterson, C. C. (2025) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2025.152017 · Cited by 2 · see citing works
Rodham, K. (2021) · Pain Management · doi:10.2217/pmt-2020-0022 · Cited by 2 · see citing works
Self-care practice and associated factors in epileptic patients: cross-sectional study, Ethiopia
Ahmed, I., Abera, A., Demeke, T., Terefa, G., Seid, S. S., & Awol, A. (2023) · Pan African Medical Journal · doi:10.11604/pamj.2023.44.36.31554 · Cited by 1 · see citing works
“Good epilepsy self-care encompasses a set of skills including good medication adherence, being able to accurately describe and document one's seizures, practicing safety precautions, having adequate rest, and managing one's stress levels [5,6].”
BackgroundGeelen, S. J. G., Niemeijer, A. S., Scholten-Jaegers, S. M. H. J., van Uden, D., Verwilligen, R. A. F., Bosma, E., & Nieuwenhuis, M. K. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5244075 · Cited by 1 · see citing works
Rodham, K. (2020) · Springer eBooks · doi:10.1007/978-3-030-48969-4_5
Self-Management: The Panacea for Coping with Persistent Pain?
Rodham, K. (2020) · Springer eBooks · doi:10.1007/978-3-030-48969-4_1
新しい医師-患者関係モデルとその可能性--R.M.ビ-チのDeep-Value-Pairingモデルを中心に
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Self-Management of Young People with Chronic Conditions: An Overview and Introduction
van Staa, A., Hilberink, S. R., & Sattoe, J. N. T. (2021) · Springer eBooks · doi:10.1007/978-3-030-64293-8_1
A MULTİDİMENSİONAL APPROACH TO CHRONİC DİSEASE MANAGEMENT: PATİENT HEALTH ENGAGEMENT MODEL
Usta, D., & Korkmaz, F. (2021) · Cyprus Journal of Medical Sciences · doi:10.5152/cjms.2021.2162
Lundell, S., Hajdarević, S., Coe, A., & Isaksson, U. (2025) · Scientific Reports · doi:10.1038/s41598-025-31228-2
“Previous self-management instruments mainly focused on self-management behaviors, strategies and self-efficacy 9 .”
Olsson, I., Kephart, G. C., Packer, T. L., Björk, S., Isaksson, U., Nordström, A., & Audulv, Å. (2026) · Quality of Life Research · doi:10.1007/s11136-025-04124-5
“In the research context, comprehensive self-management assessment measures are needed to describe, facilitate, and evaluate self-management interventions [ 17 – 20].”
Self-citationMirza, M. P., Fischer, H., & Arias, D. L. (2026) · OTJR Occupational Therapy Journal of Research · doi:10.1177/15394492261446563
Blok, S. L., Geelen, S. J. G., Hulleman, D. N., Scholten-Jaegers, S. M., van Baar, M. E., Pijpe, A., Nieuwenhuis, M. K., Bosma, E., van der Sluis, C. K., Baran, K. C., et al. (2026) · Burns · doi:10.1016/j.burns.2026.108080
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ZHANG, J., Liao, Y., Zhang, S., 韦小梅, Peng, H., He, Q., Li, D., & Wang, H. (2026) · Healthcare · doi:10.3390/healthcare14172762
- Authors
- Packer, T. L., Fracini, A., Audulv, Å., Alizadeh, N., van Gaal, B. G. I., Warner, G., & Kephart, G.
- Affiliations
- HAN University of Applied Sciences (NL)
- Dalhousie University (CA)
- Mid Sweden University (SE)
- Corresponding author
- Packer, Tanya L.
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 101
- Issue
- 4
- Pages
- 579-595
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W2766372559
- Cited by
- 54
- References
- 97
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 3 · 2023: 6 · 2022: 7 · 2021: 6 · 2020: 9 · 2019: 6 · 2018: 2
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Dalhousie University
- Topics
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Social Sciences › Education › Health Education and Validation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- self-management, chronic disease, patient-reported outcomes, patient perspectives
- MeSH terms
- Self-Management, Chronic Disease, Health Status Indicators, Humans, Self-Assessment, Self Care, Outcome Assessment, Health Care
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