Self-management approaches for people with chronic conditions: a review

Barlow, Julie H.; Wright, Chris; Sheasby, Janice; Turner, Andy; Hainsworth, Jenny

doi:10.1016/s0738-3991(02)00032-0

Cited by 2,293 publications

(2,023 citation statements)

References 127 publications

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“…Among the 10 clinics, only 4 action items in the self‐management support domain were undertaken (Table S2). Self‐management has many definitions but is understood to be an approach to chronic disease management that acknowledges patients as active participants in their treatment and encourages them to make informed decisions about care and engage in healthy behaviors 31, 32. Self‐management is poorly named for our setting because Australian Aboriginal culture universally values group identity.…”

Section: Discussionmentioning

confidence: 99%

Improving Delivery of Secondary Prophylaxis for Rheumatic Heart Disease in a High‐Burden Setting: Outcome of a Stepped‐Wedge, Community, Randomized Trial

Ralph

Dassel

Kirby

et al. 2018

JAHA

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BackgroundHealth system strengthening is needed to improve delivery of secondary prophylaxis against rheumatic heart disease.Methods and ResultsWe undertook a stepped‐wedge, randomized trial in northern Australia. Five pairs of Indigenous community clinics entered the study at 3‐month steps. Study phases comprised a 12 month baseline phase, 3 month transition phase, 12 month intensive phase and a 3‐ to 12‐month maintenance phase. Clinics received a multicomponent intervention supporting activities to improve penicillin delivery, aligned with the chronic care model, with continuous quality‐improvement feedback on adherence. The primary outcome was the proportion receiving ≥80% of scheduled penicillin injections. Secondary outcomes included “days at risk” of acute rheumatic fever recurrence related to late penicillin and acute rheumatic fever recurrence rates. Overall, 304 patients requiring prophylaxis were eligible. The proportion receiving ≥80% of scheduled injections during baseline was 141 of 304 (46%)—higher than anticipated. No effect attributable to the study was evident: in the intensive phase, 126 of 304 (41%) received ≥80% of scheduled injections (odds ratio compared with baseline: 0.78; 95% confidence interval, 0.54–1.11). There was modest improvement in the maintenance phase among high‐adhering patients (43% received ≥90% of injections versus 30% [baseline] and 28% [intensive], P<0.001). Also, the proportion of days at risk in the whole cohort decreased in the maintenance phase (0.28 versus 0.32 [baseline] and 0.34 [intensive], P=0.001). Acute rheumatic fever recurrence rates did not differ between study sites during the intensive phase and the whole jurisdiction (3.0 versus 3.5 recurrences per 100 patient‐years, P=0.65).ConclusionsThis strategy did not improve adherence to rheumatic heart disease secondary prophylaxis within the study time frame. Longer term primary care strengthening strategies are needed.Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12613000223730.

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Section: Discussionmentioning

confidence: 99%

Improving Delivery of Secondary Prophylaxis for Rheumatic Heart Disease in a High‐Burden Setting: Outcome of a Stepped‐Wedge, Community, Randomized Trial

Ralph

Dassel

Kirby

et al. 2018

JAHA

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“…The assessment includes information about the individual's relevant medical history, age, cultural influences, health beliefs and attitudes, diabetes knowledge, self-management skills and behaviors, readiness to learn, health literacy level, physical limitations, family support, and financial status (10–17,19,131,136–138). The majority of these studies support the importance of attitudes and health beliefs in diabetes care outcomes (1,68,134,135,138,139).…”

Section: Standardsmentioning

confidence: 99%

Diabetes Management in Correctional Institutions

2008

Diabetes Care

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“…Self-management is defined broadly as activities which help people to live well with their condition, maintain meaningful or pleasurable activity and achieve a good quality of life (Barlow et al 2002;Corbin and Strauss 1988;Kitwood 1997). The aim of self-management is to live as well as possible with the chronic illness, achieving a good quality of life by shaping one's life and reactions to illness (Corbin and Strauss 1992).…”

Section: Introductionmentioning

confidence: 99%

“…Common elements of many self-management courses are goal setting and activity planning, in addition to presentations and discussion of the benefits of staying active and healthy (Barlow et al 2002;Lorig and Holman 2003). These should be used in a self-management programme for people with early dementia.…”

Section: Introductionmentioning

confidence: 99%

Conceptualisation of self-management intervention for people with early stage dementia

et al. 2012

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Dementia is a major challenge for health and social care services. People living with dementia in the earlier stages experience a ''care-gap''. Although they may address this gap in care, self-management interventions have not been provided to people with dementia. It is unclear how to conceptualise self-management for this group and few published papers address intervention design. Initial focusing work used a logic mapping approach, interviews with key stakeholders, including people with dementia and their family members. An initial set of self-management targets were identified for potential intervention. Self-management for people living with dementia was conceptualised as covering five targets: (1) relationship with family, (2) maintaining an active lifestyle, (3) psychological wellbeing, (4) techniques to cope with memory changes, and (5) information about dementia. These targets were used to focus literature reviewing to explore an evidence base for the conceptualisation. We discuss the utility of the Corbin and Strauss (Unending work and care: managing chronic illness at home. JosseyBass, Oxford, 1988) model of self-management, specifically that self-management for people living with dementia should be conceptualised as emphasising the importance of ''everyday life work'' (targets 1 and 2) and ''biographical work'' (target 3), with inclusion of but less emphasis on specific ''illness work'' (targets 4, 5). We argue that selfmanagement is possible for people with dementia, with a strengths focus and emphasis on quality of life, which can be achieved despite cognitive impairments. Further development and testing of such interventions is required to provide much needed support for people in early stages of dementia.

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Self-management approaches for people with chronic conditions: a review

Cited by 2,293 publications

References 127 publications

Improving Delivery of Secondary Prophylaxis for Rheumatic Heart Disease in a High‐Burden Setting: Outcome of a Stepped‐Wedge, Community, Randomized Trial

Improving Delivery of Secondary Prophylaxis for Rheumatic Heart Disease in a High‐Burden Setting: Outcome of a Stepped‐Wedge, Community, Randomized Trial

Diabetes Management in Correctional Institutions

Conceptualisation of self-management intervention for people with early stage dementia

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