Self-care/self-help strategies for persons with Ménière’s disease: a systematic review

Abstract

Abstract:In recent years, health care practitioners and researchers have become increasingly interested in finding ways to help persons with long-standing health problems cope and live their everyday lives. This article presents the findings of the first systematic review of empirical research on the self-care strategies that persons with one such condition, Ménière's disease (MD), find helpful. It aims to provide evidence-informed guidance to persons with MD on self-help/self-care approaches they might pursue. Searches were undertaken on three databases (MEDLINE, CINAHL, and PsycINFO), locating 239 potentially relevant references relating to MD or symptoms associated with the condition. Following a screening and critical appraisal process undertaken by the authors, eight papers were included in the review and were judged to be of high or good quality. The papers were synthesized in a narrative form, with individual papers summarized in evidence tables. No single self-help/self-care strategy or coping mechanism was evident. The review found evidence of the potential of a diverse range of helpful self-care approaches, including a cognitive behavioral therapy-self-help intervention, changes in lifestyle, developing and adopting positive approaches and/or avoidance of precipitating factors, and complementary and alternative medicine. The key message, for persons with MD and their caring health practitioners, is to become aware of the multiplicity of potential strategies and to try with support from others to "find what works, why and how" for themselves in their own psycho-socio-cultural lifeworld. More research is needed to examine people's search for self-care strategies and obtain insight into how and why these work for them, drawing on notions of pragmatic acculturation, health literacy, and human/health agency, in addition to further research on the potential of, and who might benefit most from, cognitive behavioral therapy-self-help interventions.

Living with Ménière’s disease: an interpretative phenomenological analysis

“…Offers of support, for example, may have paradoxically added to the psychological burden of living with this condition by working to undermine the sense of self within the family over time. Consistent with the views of Long and Brettle [32], our findings suggest that it would be useful for physiotherapists and other rehabilitation professionals to understand the ongoing narrative of an individual's life with M eni ere's, how they configure their lives, and the cognitive, physical, and emotional work that accompanies living with this condition. Our findings underline the need for physiotherapists in the UK to continue to use a biopsychosocial approach [29] and to draw on the expertise of other healthcare professionals such as psychologists who may be best placed to offer further insights and advice.…”

“…Psychological therapies and peer support groups that aim to improve the understanding of M eni ere's disease, increase participation in everyday life, and diminish the negative impact on quality of life and psychosocial functioning have been advocated [2,13,30,31]. Multiple self-help and self-care strategies, such as developing and adopting positive approaches, and/or avoidance of precipitating factors, as well as complementary and alternative medicine, have been identified and positively appraised by people living with M eni ere's disease [32]. Common elements of these strategies include; pursuing self-health agency and searching for a sense of self, regaining control over health and life in general, and receiving support from significant others and healthcare practitioners [32].…”

“…Multiple self-help and self-care strategies, such as developing and adopting positive approaches, and/or avoidance of precipitating factors, as well as complementary and alternative medicine, have been identified and positively appraised by people living with M eni ere's disease [32]. Common elements of these strategies include; pursuing self-health agency and searching for a sense of self, regaining control over health and life in general, and receiving support from significant others and healthcare practitioners [32]. However, despite evidence that healthcare professionals appreciate the relevance of adopting a collaborative, patientfocussed approach, a comparison of current practice for people with M eni ere's disease against best practice models for chronic illness revealed that current care practices may not meet patients' needs or facilitate high-quality outcomes due to a lack of coordinated care and limited support for patients to actively participate in their own care [33].…”