Chronic condition self-management: Expectations of responsibility

Abstract

ObjectiveWhile self-management has been shown to be beneficial for many patients it assumes and encourages a particular conception of responsibility and self-management that may not fit with all patients' experience of their chronic conditions and their management. It therefore warrants further examination. MethodsWe examine the concept of self-management and responsibility from a range of standpoints. ResultsAll attempts to meet people's needs run the risk of imposing specific conceptions of how people should live their lives. While self-management appears to be consistent with placing patient needs, values and priorities at the heart of health care, it might be more problematic for some patients. ConclusionsThe context in which patients seek self-management support from health services, and how their needs and preferences are listened to by health professionals, are critical if the collaborative selfmanagement partnership between them is to be effectively realized. Practice ImplicationsProviding services without reflecting on the meaning of self-management for the person with chronic conditions creates unintended assumptions about responsibility, engagement and care provision which may serve to alienate and further stigmatise some patients. Often, these are the very patients with complex needs who need such service support the most.

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