Supporting self-management in patient with chronic illness

Department of Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA.
American family physician (Impact Factor: 2.18). 11/2005; 72(8):1503-10.
Source: PubMed


Support of patient self-management is a key component of effective chronic illness care and improved patient outcomes. Self-management support goes beyond traditional knowledge-based patient education to include processes that develop patient problem-solving skills, improve self-efficacy, and support application of knowledge in real-life situations that matter to patients. This approach also encompasses system-focused changes in the primary care environment. Family physicians can support patient self-management by structuring patient-physician interactions to identify problems from the patient perspective, making office environment changes that remove self-management barriers, and providing education individually and through available community self-management resources. The emerging evidence supports the implementation of practice strategies that are conducive to patient self-management and improved patient outcomes among chronically ill patients.


Available from: Mary Coleman
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    • "[6] Self management for chronic diseases is a well established principle. [7] [8] [9] However, there is little information available to those who are interested in implementing or purchasing such programs as to its effect on health amongst patients taking antiretroviral therapy. CD4 cell count measurement is means used by the study to measure effect on health of HIV/AIDS patients to help them decide how to design or structure their programs. "
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    ABSTRACT: This paper reports on the impact of an intervention to encourage self-management of treatment upon CD4 ratios and health status of HIV/AIDS patients: a quasi experimental study in a semi-rural area in KwaZulu-Natal province in South Africa. Participants were a purposive sample of 88 HIV/AIDS patients. Participant's CD4 cell count results were retrieved from the clinic records and a questionnaire was administered pre-and post-intervention after twelve weeks. Paired Samples Test results reveal a statistically significant difference between the mean CD4 counts pre-and post-intervention for both groups. However, the differences between means for both groups deviated from one another significantly. The intervention group shows a higher mean difference. For the intervention group the difference between means was-178.09, while –72.29 was the difference between means for the control group. Post-intervention results showed that the intervention and control groups are statistically significantly different in terms of CD4 count mean scores (t = 3.741; df = 80; p = .000 < .05); and their mean scores on physical functioning (t = 3.900; df = 79; p = .000 < .05), vitality (t = 3.285; df = 79; p = .002 < .05) and general health (t = 2.107; df = 79; p = .039 < .05), physical health (p = .001< .05) and role limitation due to emotional problem (p = .007 < .05). The study demonstrated that self-management education impact positively and significantly on the mean CD4 cell counts and health status of HIV/AIDS patients. The findings suggests that combining self-management education with highly active antiretroviral therapy may improve health care of HIV/AIDS patients in resource limited rural setting and most likely in other settings.
    10/2015; 5(12). DOI:10.5430/jnep.v5n12p25
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    • "But this is no simple dichotomy between 'doctor knows best' or shared inclusive decision-making, rather it is a constant tension at the heart of trying to 'do the right thing' when aspiring to be patient centred while grappling with the very real asymmetries in knowledge, experience and expertise between health professionals, informatics specialists and patients [20]. From the perspective of supporting patients to build self-efficacy for selfmanagement it is evident that from the outset of these projects, individual patients had differential levels of confidence and capacity to self-manage [21]. Patients were therefore in a liminal state of transition in their capacities, skills and desire to self-manage. "
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    ABSTRACT: This chapter explores how Techno-Anthropology can contribute to more explicitly professional and ethically responsible reflections on the socio-technical practices involved in meaningfully engaging patients in health informatics research. The chapter draws on insights from health informatics research projects focused on chronic disease and self-management conducted in Tasmania during the last 10 years. Through these projects the paper explores three topics of relevance to 'meaningful engagement' with patients: (i) Patient Self-Management and Chronic Disease (ii) Patients as Users in Health Informatics research, and, (iii) Evaluations of outcomes in Health and Health Informatics Interventions. Techno-Anthropological reflections are then discussed through the concepts of liminality, polyphony and power. This chapter argues that beyond its contribution to methodology, an important role for Techno-Anthropology in patient centred health informatics research may be its capacity to support new ways of conceptualising and critically reflecting on the construction and mediation of patients' needs, values and perspectives.
    Studies in health technology and informatics 08/2015; 215:52-66.
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    • "Anxieties about leaving pediatric care, difficulty finding an adult doctor, handling financial issues and parental overprotection have also been identified as barriers to transition (de Montalembert & Guitton, 2014; Mennito, Hletko, Ebeling, Amann, & Roberts, 2014). Successful transition to adult care in SCD is linked to better outcomes and improvements in self-care regimens (Lenoci, Telfair, Cecil, & Edwards, 2002), resulting in substantial reductions in morbidity and mortality (Hauser & Dorn, 1999; Telfair, Alexander, Loosier, Alleman-Velez, & Simmons, 2004; Wojciechowski et al., 2002) and overall managed care costs (Coleman & Newton, 2005). Assessment of transition readiness can guide individualized interventions that promote appropriate patient education and skill development (Cooley, 2004; Ellingford, 2006). "
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    ABSTRACT: Adolescents and young adults (AYAs) often transfer from pediatric to adult care without adequate preparation, resulting in increased morbidity and mortality. The purpose of this descriptive research study of parent/AYA dyads was to measure perceptions of transition readiness. Factors that were found to be associated with perceptions of increased readiness to transition included AYA age, the amount of responsibility AYAs assume for their healthcare and the degree of parent involvement. More attention should be focused on these aspects of care to improve transition from pediatric to adult care for AYAs with sickle cell disease. Copyright © 2015. Published by Elsevier Inc.
    Journal of pediatric nursing 07/2015; 30(5). DOI:10.1016/j.pedn.2015.06.008 · 1.01 Impact Factor
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