The CDSMP is a structured self-management programme
which consists of six weekly group sessions of two and a half
hours each. The programme incorporates four strategies to
enhance self-efficacy expectancies: skills mastery, reinterpretation
of symptoms, modelling and social persuasion (Lorig
et al. 1999, 2001a, 2001b, Lorig & Holman 2003). Skills
mastery includes goal-setting and action-planning, which can
be considered as core activities of the CDSMP since they take
up 25–35% of each session. Reinterpreting symptoms comprises
cognitive symptom management techniques and deals
with relieving symptom problems. By modelling and social
persuasion, either through group participants or leaders,
patients in the class are expected to become motivated to
change their behaviours and beliefs. During the first session,
patients received the reference book Living a healthy life with
chronic conditions