scholarly journals Providing and receiving self-management support for chronic illness: Patients and health practitioners' assessments

2010 ◽  
Vol 2 (2) ◽  
pp. 124 ◽  
Author(s):  
Jenny Carryer ◽  
Claire Budge ◽  
Chiquita Hansen ◽  
Katherine Gibbs
Keyword(s):  
Chronic Illness ◽  
Self Report ◽  
Self Management ◽  
Health Board ◽  
Team Approach ◽  
Management Support ◽  
Primary Nursing ◽  
Primary Health ◽  
Health Practitioners ◽  
The Individual

INTRODUCTION: Providing care for people with chronic illness is a major issue for health practitioners around the world, especially as populations age. Encouraging self-management is beneficial in terms of relieving the burden on the health system and promoting better health and adherence to medication and advice amongst this group. AIM: To measure the level of self-management support being provided to and received by people living with chronic illness in a District Health Board (DHB) region. METHODS: Self-report questionnaires (PACIC) were completed by 341 people living with chronic illness to measure the self-management support they receive from general practitioners and nurses. A modified version of the PACIC was used with 12 GPs and 77 primary health nurses in the same region to assess the provision of self-management support. RESULTS: Patients’ assessments suggest that they are receiving intermittent self-management support for their chronic illness. A comparison of ratings of different health practitioners revealed that nurses were reported to be providing support more consistently than GPs. The health practitioners rated themselves as providing self-management support more often than the patients reported receiving it. Many clinicians also suggested that not all forms of support are appropriate for everyone, suggesting the need to tailor support to the individual. DISCUSSION: Chronic illness support needs to be considered within the context of the individual and to be embedded in an ongoing relationship between the person and the provider. Findings highlight the benefits of a multidisciplinary team approach to self-management support and education in chronic illness care. KEYWORDS: Chronic disease; self care; primary health care; primary nursing care; physicians, family

scholarly journals Modifying the PACIC to assess provision of chronic illness care: An exploratory study with primary health care nurses

2010 ◽  
Vol 2 (2) ◽  
pp. 118 ◽  
Author(s):  
Jenny Carryer ◽  
Claire Budge ◽  
Chiquita Hansen ◽  
Katherine Gibbs
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Care Delivery ◽  
Self Management ◽  
Chronic Illness Care ◽  
Management Support ◽  
Primary Health ◽  
Health Practitioners ◽  
Primary Health Care Nurses

INTRODUCTION: In line with Wagner’s Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioner’s perspective would enable individual practitioners to evaluate their own provision of self-management support, and would also enable a more direct comparison between care provided and care received within the chronic illness context. AIM: To explore the potential of a modified PACIC instrument to assess individual health practitioners’ delivery of care to chronic illness patients with a sample of primary health care nurses. METHODS: Seventy-seven primary care nurses completed the modified PACIC, reworded to ask about care provision rather than receipt of care. An additional seven cultural sensitivity items were included, as were questions about the suitability of the types of chronic illness care and who should be providing the care. RESULTS: The modified PACIC items appear to be appropriate for use with health practitioners. Agreement that the types of care described in the PACIC should be provided was almost unanimous, and the predominant view was that self-management support should be provided by both nurses and doctors. Mean scale scores were higher than those generally reported from studies using the PACIC. DISCUSSION: The results of this first evaluation of a modified PACIC suggest that the original items plus the cultural sensitivity items can be used to assess self-management support by individual health practitioners. KEYWORDS: Chronic illness; self-management; primary health care, nurses

Self-Management Support in Chronic Illness Care: A Concept Analysis

2012 ◽  
Vol 26 (2) ◽  
pp. 108-125 ◽  
Author(s):  
Jennifer Kawi
Keyword(s):  
Chronic Illness ◽  
Theory Development ◽  
Concept Analysis ◽  
Self Management ◽  
Chronic Illness Care ◽  
Team Approach ◽  
Clear Understanding ◽  
Management Support ◽  
Patient Centered ◽  
Adequate Knowledge

Purpose: This article reports on the concept analysis of self-management support (SMS) to provide clarity for systematic implementation in practice. Background: SMS is a concept in its early phase of development. It is increasingly evident in literature on chronic illness care. However, the definition has been simplified or vague leading to variable SMS programs and inconsistent outcomes. Elucidation of SMS is necessary in chronic illness care to facilitate clear understanding and implementation. Method: Rodgers’ evolutionary concept analysis method was used to examine SMS. Data sources included systematic multidisciplinary searches of multiple search engines. Results: SMS refers to comprehensive sustaining approaches toward improving chronic illness outcomes consisting of patient-centered attributes (involving patients as partners; providing diverse, innovative educational modalities specific to patients’ needs; individualizing patient care), provider attributes (possessing adequate knowledge, skills, attitudes in providing care), and organizational attributes (putting an organized system of care in place, having multidisciplinary team approach, using tangible and social support). Implications: A well-clarified SMS concept is important in theory development. The attributes offer necessary components in SMS programs for systematic implementation, evaluation, and research. There is great potential that SMS can help improve outcomes of chronic illness care.

Self-management support preferences of people with asthma or chronic obstructive pulmonary disease: A systematic review and meta-synthesis of qualitative studies

2019 ◽  
pp. 174239531986944 ◽  
Author(s):  
Selena O’Connell ◽  
Vera JC McCarthy ◽  
Eileen Savage
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Healthcare Professionals ◽  
Qualitative Studies ◽  
Self Management ◽  
Chronic Obstructive ◽  
Management Support ◽  
Obstructive Pulmonary Disease ◽  
The Individual ◽  
Behavioural Sciences

Objectives To synthesise findings from qualitative studies on the preferences of people with asthma or chronic obstructive pulmonary disease (COPD) for self-management support. Methods A thematic synthesis of literature was carried out. Six databases (ASSIA, CINAHL, MEDLINE, PsycINFO, Psychology and the Behavioural Sciences and SSCI) were used to search for qualitative studies eliciting perspectives of adults with asthma and/or COPD on self-management support, published between May 2008 and April 2018. Results A total of 968 articles were retrieved across databases, with 15 articles included in the synthesis. Three themes were identified: Types of Support described the range of supports valued by participants in the studies, particularly education provided by competent healthcare professionals; The Support Relationship highlighted the importance of a collaborative relationship with one’s healthcare professional which was characterised by communication, trust and continuity over time and Accessibility identified the considerations of participants relating to physically accessible, prompt support which is provided in a format preferred by the individual. Discussion Increased understanding of patients’ preferences may provide insight which can be used to enhance engagement with self-management support. Further research needs to examine self-management support preferences outside the context of evaluating interventions for people with asthma/COPD and needs to address the optimal means of enhancing accessibility.

An evaluation of the self-management support capacity of providers of chronic condition primary care

2012 ◽  
Vol 18 (2) ◽  
pp. 112 ◽  
Author(s):  
Tracy E. Cheffins ◽  
Julie A. Twomey ◽  
Jane A. Grant ◽  
Sarah L. Larkins
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Chronic Condition ◽  
Health Care Services ◽  
Readiness To Change ◽  
Structured Interview ◽  
Self Management ◽  
Management Support ◽  
Primary Health

Self-management support (SMS) is an important skill for health professionals providing chronic condition management in the primary health care sector. Training in SMS alone does not always lead to its utilisation. This study aimed to ascertain whether SMS is being used, and to identify barriers and enablers for SMS in practice. Health professionals who underwent SMS training were invited to participate in a semi-structured interview. A response rate of 55% (14 of 24) was achieved. All interviewees rated their understanding of the principles of SMS as moderate or better. In relation to how much they use these principles in their practice, several (5 of 14) said minimally or not at all. The tools they were most likely to use were SMART goals (8 of 14) and decision balance (5 of 14). Core skills that were being used included problem solving (11 of 14), reflective listening (13 of 14), open-ended questions (12 of 14), identifying readiness to change (12 of 14) and goal setting (10 of 14). The most important barriers to implementing SMS were current funding models for health care, lack of space and staff not interested in change. The most highly rated enabling strategies were more training for general practitioners and more training for practice nurses; the lowest rated was more training for receptionists. The increasing prevalence of chronic conditions due to ageing and lifestyle factors must be addressed through new ways of delivering primary health care services. Self-management support is a necessary component of such programs, so identified barriers to SMS must be overcome.

e-Patients Perceptions of Using Personal Health Records for Self-management Support of Chronic Illness

2015 ◽  
Vol 33 (6) ◽  
pp. 229-237 ◽  
Author(s):  
PERRY M. GEE ◽  
DEBORA A. PATERNITI ◽  
DEBORAH WARD ◽  
LISA M. SOEDERBERG MILLER
Keyword(s):  
Chronic Illness ◽  
Personal Health Records ◽  
Self Management ◽  
Personal Health ◽  
Management Support ◽  
Health Records

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management.Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis.Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joel Freilich ◽  
Gunnar H. Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals. Conclusion Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

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