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A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II).

Chronic diseases such as arthritis, diabetes, and heart disease that cause pain, functional impairment, social and emotional dysfunction, and premature loss of wage earnings constitute a challenging problem for American society. In the absence of any effective cure for these frequently progressive conditions, the secondary prevention of complications, which requires a high degree of communication and cooperation between patient and clinician, and improving quality of life and functional capacity through better disease self-management becomes critical and are key objectives of Healthy People 2010. Part I of this two-part article described the common clinical features of chronic disease, the diverse disease management strategies used for alleviating pain and preventing disability, and the role of self-efficacy as a framework for intervention. This companion article identifies and synthesizes the key research evidence for educational interventions designed to enhance individual self-efficacy perceptions and presents implications for improving practices in patient education for chronic diseases.