Article

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

ABSTRACT

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.

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    • "However, we have less confidence and scant evidence that ''a broad spectrum'' of patients is actually informed, engaged, and empowered to participate as partners. ''Despite this encouraging evidence, self-management is the least implemented and most challenging area of chronic disease management''[3]. Why is there such a gap between the seemingly consensual common sense of the value of patient engagement and patient participation in the real world? "

    Preview · Article · Jan 2016 · The Patient: Patient-Centered Outcomes Research
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    • "Central to the effective delivery of care is the support of individuals' self-management abilities (Wagner et al. 1996, Bodenheimer et al. 2002, Wagner 2011). For people with chronic illness or disability , self-management support must extend beyond the traditional focus on acute care to include the fostering of problem-solving skills, self-efficacy, and methods of approaching and coping with life situations that are important to individuals (Coleman & Newton 2005). This form of care is holistic, with a focus on the person rather than the disease (Mead & Bower 2000), including the strengthening of a person's ability to maintain overall quality of life and well-being (Cramm & Nieboer 2012, Nieboer 2013). "
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    ABSTRACT: The objective of the study was to determine whether community nurses in the Netherlands improve self-management abilities and quality of life of frail community-dwelling people. This longitudinal study was performed in the context of a larger evaluation study of the ‘Zichtbare Schakels’(Visible Link) programme, conducted to determine the quality of care provided by community nurses to community-dwelling frail people in Rotterdam, the Netherlands. For the current study, clients seen by community workers in Rotterdam between July 2013 and November 2014 participated. Data were gathered via personal interviews by the community nurses as part of care delivery at the start (T0; n = 220) and end of care delivery (T1; n = 111 – the remaining 109 clients were still receiving care) to evaluate and improve quality of care. We measured client's quality of life (using the EQ5D), self-management abilities (using the Self-Management Ability Scale) and background characteristics. Results showed that clients seen by the community nurses especially experience problems when it comes to usual activities and pain/discomfort. Furthermore, quality of life was much worse among clients of the community nurses (0.51) than among frail older (aged ≥70 years) people in Rotterdam (0.61), Dutch patients with chronic illnesses [CVD (0.83), COPD (0.79) or diabetes (0.83)] and older (aged ≥65 years) people who had recently been hospitalised (0.80). Significant improvements were seen in client's self-management and quality of life over time. Self-management abilities at T0 and changes in self-management abilities (T1 – T0) clearly predicted quality of life at T1. Investing in community health nurses may be beneficial for the improvement of self-management abilities and quality of life among very frail people in the community.
    Full-text · Article · Jan 2016 · Health & Social Care in the Community
    • "Healthcare providers are therefore increasingly expected to help patients understand their own central role in managing their illness, make informed choices and engage in healthy behaviour [5] [11]. "
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    ABSTRACT: Healthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management.
    No preview · Article · Dec 2015
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