Chronic disease self-management: A hybrid concept analysis

Abstract

Background Chronic diseases require chronic disease self-management (CDSM). Existing CDSM interventions, while improving outcomes, often do not lead to long-lasting effects. To render existing and new CDSM interventions more effective, an exploration of the concept of CDSM from both the literature and patient perspectives is needed. Purpose To describe the current conceptualization of CDSM in the literature, identify potential inadequacies in this conceptualization based on a comparison of literature- and patient-based CDSM descriptions, and to offer a more comprehensive definition of CDSM. Method A hybrid concept analysis was completed. Discussion In the literature, CDSM is defined as behaviors influenced by individual characteristics. Patients in the fieldwork phase discussed aspects of CDSM not well-represented in the literature. Conclusions CDSM is a complex process involving behaviors at multiple levels of a person's environment. Pilot work to develop and test CDSM interventions based on both individual and external characteristics is needed.

An Intervention to Enhance Goals-of-Care Communication Between Heart Failure Patients and Heart Failure Providers

“…The patient GoC intervention, guided by the self-management for chronic conditions model 29 and a prior intervention 30 included: 1) telephone-based pre-visit coaching conducted by a nurse where the patient identified current perceived barriers and facilitators to communication with the cardiology provider, 30 education about standard HF therapies, patient preferences for communication about end-of-life care, and completion of the Five Wishes advance directive form; 2) a one-page patient activation outline that was constructed from pre-visit coaching call that was shared with both the patient and their HF provider, along with suggestions for addressing barriers and using facilitators; and 3) patient activation, skills enhancement, and role playing conversation openers to initiate a GoC discussion with the provider at the next upcoming HF clinic visit. At the conclusion of telephone coaching, participants were asked to rate desire and confidence to engage in a GoC conversation with their HF provider, using a 0–10 scale (0= definitely no – 10=definitely yes), and to designate their desired role in shared decision making.…”

Knowledge mobilisation: an ethnographic study of the influence of lay mindlines on eczema self-management in primary care in the UK

“…Self-management of long-term conditions is a policy imperative 23–25. There is no agreed definition of self-management26; it is broadly concerned with sustained efforts to maintain or improve health.…”

Self-care of young people with long-term physical and mental health conditions

“…Many interventions have an individual behaviour change focus although researchers are now beginning to consider using more comprehensive theories to build interventions such as socioecological theory and social network theory (Miller et al 2015). In addition it was evident, particularly in the mental health review, that researchers had frequently tried to ensure consistency in intervention delivery usually by using manualised approaches.…”

“…Furthermore it has been noted that professionals' understandings of self-care and self-management are based on a model of compliance rather than empowerment (Sawyer and Aroni 2005;Sadler et al 2014;Dwarswaard et al 2015). A common criticism is that self-care and self-management tend to focus on the individual and changing their behaviour; neglecting not only their social context and lay understandings of long-term illness but also the influence and roles played by families and social networks (Rosland and Piette 2010;Audulv 2013;Ong et al 2014;Sadler et al 2014;Dwarswaard et al 2015;Miller et al 2015). This is particularly pertinent in relation to children/young people as parents play an important role in self-management/care and peers exert an influence over beliefs and behaviours.…”