What skills do primary health care professionals need to provide effective self-management support?Seeking consumer perspectives

Abstract

ObjectiveThis research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self -management (CCPSM) support, according to the perceptions of a sample of Australian consumers and carers. MethodsQualitative data was collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. ResultsWith the exception of health professionals specifically trained or currently working in this area, consumers and carers perceive there is a lack of understanding, competence and practice of CCPSM support among PHC professionals. DiscussionThe PHC workforce appears not to have the full set of skills needed to meet the growing burden of chronic conditions on the health system. Recommendations include education and training that focuses on improved communication skills, knowledge of community support resources, identification of consumers' strengths and current capacities, collaborative care with other health professionals, consumers and carers, and psychosocial skills to understand the impact of chronic conditions from the person's perspective.

In it together: Physical health and well-being for people with mental illness

“…We have highly fragmented systems of care; we don't talk to each other very well, we palm off responsibility to each other, or we 'forget' about the whole picture of the person's journey when they leave our office (Lawn et al, 2009). And many people with mental illness have had bad experiences in mental and physical healthcare systems, so of course they're going to be…”

Chronic condition self-management: Expectations of responsibility

“…Yet, genuine sharing of expertise and power across the divide of patient and health worker needs more than general ideals and intentions. Many patients expect health workers to be 'the expert' and many health workers believe they include patients in decisions about care, even when patients' feedback is that they do not always do so [8]. Hence, some structured rules for engagement seem to be needed; some means of operationalizing the ideals of patient-centred care that will satisfy both patients and health professionals.…”

Barriers and enablers to good communication and information-sharing practices in care planning for chronic condition management

“…2 However, research reveals that general practitioners (GPs) rarely discuss care planning with other health professionals, and patients do not generally expect to participate in these discussions, which detracts from the possibility of genuine collaboration (Shortus et al 2007). Little is known about why care planning has been of limited success or what the barriers and enablers are to effective communication between health-care workers, patients and carers (Simon et al 2008;Jowsey et al 2009;Lawn et al 2009;Mathers et al 2011). 1We have used the term 'condition' to include diseases and conditions such as cardiac and respiratory diseases and mental disorders. 2Wedefine 'communication and information sharing' as the transfer of information between patients and theirPHCworkers, oramongworkers.…”