“It all needs to be a full jigsaw, not just bits”: exploration of healthcare professionals’ beliefs towards supported self-management for long-term conditions

Abstract

Background Long-Term Conditions are physical health issues which profoundly impact physical and psychological outcomes and have reached epidemic worldwide levels. An increasing evidence-base has developed for utilizing Supported Self-Management to ensure Health, Social Care & Voluntary staff are knowledgeable, skilled, and experienced to enable patients to have the confidence and capability to self-manage their conditions. However, despite Health Psychology theories underpinning chronic care models demonstrating beliefs are crucially associated with intention and behaviour, staff beliefs towards Supported Self-Management have received little attention. Therefore, the study aimed to explore healthcare professionals’ beliefs towards Supported Self-Management for Long-Term Conditions using the Theory of Planned Behaviour . Methods A mixed-methods approach was conducted within a single UK local government authority region in 2 phases: (1) Qualitative focus group of existing Supported Self-Management project staff ( N = 6); (2) Quantitative online questionnaire of general Long-Term Conditions staff ( N = 58). Results (1) Eighty two utterances over 20 theme sub-codes demonstrated beliefs that Supported Self-Management improves healthcare outcomes, but requires enhancements to patient and senior stakeholder buy-in, healthcare culture-specific tailoring, and organizational policy and resources; (2) Mean scores indicated moderate-strength beliefs that Supported Self-Management achieves positive healthcare outcomes, but weak-strength intentions to implement Supported Self-Management and beliefs it is socially normative and perceived control over implementing it. Crucially, regression analyses demonstrated intentions to implement Supported Self-Management were only associated with beliefs that important others supported it and perceived control over, or by whether it was socially encouraged. Conclusions Healthcare professionals demonstrated positive attitudes towards Supported Self-Management improving healthcare outcomes. However, intentions towards implementing this approach were low with staff only slightly believing important others (including patients and clinicians) supported it and that they had control over using it. Future Supported Self-Management projects should seek to enhance intention (and consequently behaviour) through targeting beliefs that important others do indeed actually support this approach and that staff have control over implementing it, as well as enhancin...

Experiences of living with long COVID and of accessing healthcare services: a qualitative systematic review

“…1 17–19 Social media and support groups are widely used for other health conditions 22 but are generally considered complementary to healthcare services; part of the ‘jigsaw’ that makes supported self-management successful. 23 Therefore, there appears to be a need for more widespread understanding of and information about long COVID, and people with lived experience are ideally placed to contribute their expert opinion.…”

Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis

“…Whilst the literature suggests healthcare professionals hold positive attitudes towards supportive self-management to improve patient outcomes, this does not always translate into intention and practice. Healthcare professionals also demonstrate uncertainty around what self-management is and how it can best be supported, therefore more education is needed for staff as well, to ensure adequate understanding of self-management and the healthcare professionals role in providing support [ 67 ].…”

Use of the behaviour change wheel to improve everyday person-centred conversations on physical activity across healthcare

“…Healthcare professionals perceive conversations around physical activity and supported self-management as important [84,91] but those who lack confidence in their skills give physical activity advice infrequently [16,84]. Furthermore, those who counsel patients regularly expect to be moderately or very successful, whereas those who seldom initiate physical activity discussions rarely expect them to make a difference [75].…”

“…One-sided, transactional conversations dominate this approach, failing to explore the individual's perspective [12]. Training that focuses on building positive attitudes, self-efficacy and intentions may provide an effective strategy to address this [91,94].…”