Globally, healthcare systems are being affected by the rapid, dynamic changes in advancements in biomedical science, newer technologies, the expansion of informatics, and the ability to meet the needs of diverse populations Centers for Disease Control and Prevention. Meanwhile, evidence is mounting on the concerns of millions coping with chronic illnesses.

In 2010, the National Institutes of Health indicated that 133 million adults have at least one chronic disease. Ryan and Sawin (2009) estimated “half of all Americans are managing a serious chronic health condition at home”. Therefore, a major concern for nurses, patient educators, and program developers is determining what the best practices are for teaching self-management to people with chronic diseases.