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

2009 ◽  
Vol 15 (1) ◽  
pp. 37 ◽  
Author(s):  
Sharon Lawn ◽  
Malcolm Battersby ◽  
Helen Lindner ◽  
Rebecca Mathews ◽  
Steve Morris ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Community Support ◽  
Self Management ◽  
Management Support ◽  
Primary Health ◽  
The Impact

This research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self-management support, according to the perceptions of a sample of Australian consumers and carers. Qualitative data were collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. With 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 chronic condition prevention and self-management support among PHC professionals. The 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.

An evaluation of the self-management support capacity of providers of chronic condition primary care

2012 ◽  
Vol 18 (2) ◽  
pp. 112 ◽  
Author(s):  
Tracy E. Cheffins ◽  
Julie A. Twomey ◽  
Jane A. Grant ◽  
Sarah L. Larkins
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Professionals ◽  
Chronic Condition ◽  
Health Care Services ◽  
Readiness To Change ◽  
Structured Interview ◽  
Self Management ◽  
Management Support ◽  
Primary Health

Self-management support (SMS) is an important skill for health professionals providing chronic condition management in the primary health care sector. Training in SMS alone does not always lead to its utilisation. This study aimed to ascertain whether SMS is being used, and to identify barriers and enablers for SMS in practice. Health professionals who underwent SMS training were invited to participate in a semi-structured interview. A response rate of 55% (14 of 24) was achieved. All interviewees rated their understanding of the principles of SMS as moderate or better. In relation to how much they use these principles in their practice, several (5 of 14) said minimally or not at all. The tools they were most likely to use were SMART goals (8 of 14) and decision balance (5 of 14). Core skills that were being used included problem solving (11 of 14), reflective listening (13 of 14), open-ended questions (12 of 14), identifying readiness to change (12 of 14) and goal setting (10 of 14). The most important barriers to implementing SMS were current funding models for health care, lack of space and staff not interested in change. The most highly rated enabling strategies were more training for general practitioners and more training for practice nurses; the lowest rated was more training for receptionists. The increasing prevalence of chronic conditions due to ageing and lifestyle factors must be addressed through new ways of delivering primary health care services. Self-management support is a necessary component of such programs, so identified barriers to SMS must be overcome.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management.Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis.Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Joel Freilich ◽  
Gunnar H. Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals. Conclusion Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

Community Health Intervention Program (Chip): Re-Educating Health Professionals for Primary Health Care

1987 ◽  
Vol 8 (1) ◽  
pp. 81-90 ◽  
Author(s):  
I. N. Egwu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Development ◽  
Health Professionals ◽  
Urban Poor ◽  
Intervention Program ◽  
Care Delivery ◽  
Care Community ◽  
Primary Health ◽  
The Impact

Primary health care (PHC) in most developing countries remains largely inaccessible to a vast proportion of urban and rural populations. It is neither influenced by, nor integrated with, preventive care/community development. This may be attributed partly to lack of community participation by communities. Professional health care is isolated and impervious to the influence of health care users. In Nigeria all functional correlates are available in the existing health systems; yet, the impact is not felt. What is needed, and urgently, is an intervention to extend meaningful health care delivery into the urban poor and rural communities. The Nigerian Youth Service Corps (NYSC) scheme, through a rational and systematic mobilization and utilization of its health manpower, offers an excellent opportunity to demonstrate that PHC can work. A two-step intervention process is proposed: a reorientation during NYSC “orientation,” and a community-based practice module, during the NYSC “Primary Assignment” phase. Health professionals working as a “team,” and led by NYSC doctor(s), undertake their medical care responsibilities as well as community development projects as integrated aspects of PHC. It is envisaged that experiences accruing from such a deliberate intervention with a pilot project, will form a basis for operational adoption of the proposed CHIP as a national model.

scholarly journals Using the Self-Management Assessment Scale for Screening Support Needs in Type 2 Diabetes: Qualitative Study (Preprint)

2019 ◽  
Author(s):  
Ulrika Öberg ◽  
Carl Johan Orre ◽  
Åsa Hörnsten ◽  
Lena Jutterström ◽  
Ulf Isaksson
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Screening Instrument ◽  
The Self ◽  
Self Management ◽  
Management Support ◽  
Primary Health

BACKGROUND Globally, most countries face a common challenge by moving toward a population-based structure with an increasing number of older people living with chronic conditions such as type 2 diabetes. This creates a considerable burden on health care services. The use of digital tools to tackle health care challenges established views on traditional nursing, based on face-to-face meetings. Self-management is considered a key component of chronic care and can be defined as management of the day-to-day impact of a condition, something that is often a lifelong task. The use of a screening instrument, such as the Self-Management Assessment Scale (SMASc), offers the potential to guide primary health care nurses into person-centered self-management support, which in turn can help people strengthen their empowerment and self-management capabilities. However, research on self-management screening instruments is sparse, and no research on nurses’ experiences using a digitalized scale for measuring patients’ needs for self-management support in primary health care settings has been found. OBJECTIVE This paper describes diabetes specialist nurses’ (DSNs) experiences of a pilot implementation of the SMASc instrument as the basis for person-centered digital self-management support. METHODS This qualitative study is based on observations and interviews analyzed using qualitative content analysis. RESULTS From the perspectives of DSNs, the SMASc instrument offers insights that contribute to strengthened self-management support for people with type 2 diabetes by providing a new way of thinking and acting on the patient’s term. Furthermore, the SMASc was seen as a screening instrument with good potential that embraces more than medical issues; it contributed to strengthening person-centered self-management support, and the instrument was considered to lead both parts, that is, DSNs and patients, to develop together through collaboration. CONCLUSIONS Person-centered care is advocated as a model for good clinical practice; however, this is not always complied with. Screening instruments, such as the SMASc, may empower both nurses and patients with type 2 diabetes with more personalized care. Using a screening instrument in a patient meeting may also contribute to a role change in the work and practice of DSNs.

scholarly journals O olhar das pessoas com deficiência visual sobre o acesso à informação nos cuidados de saúde primários

2021 ◽  
pp. 225
Author(s):  
RITA PEREIRA ◽  
CARLA FREIRE
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Visual Impairment ◽  
Health Centers ◽  
Self Management ◽  
Primary Health ◽  
Visually Impaired People ◽  
Accessible Information ◽  
Loss Of Autonomy ◽  
The Impact

  Considerando os direitos da pessoa com deficiência visual e a necessidade do ambiente se adaptar à diversidade de públicos, pretende-se compreender em que medida os centros de saúde de Portugal respondem às suas necessidades de comunicação e de interação no acesso aos cuidados de saúde primários. Os dados deste estudo, exploratório-descritivo, resultaram do preenchimento de um inquérito por questionário 124 pessoas com deficiência visual. Conclui-se que os centros de saúde não respondem às necessidades da maioria dos participantes, sendo as consequências deste facto a perda de autonomia, privacidade e informações importantes, para além de serem, também, percecionadas algumas barreiras que se prendem a questões interpessoais. Os resultados obtidos reforçam a importância de sensibilizar, por um lado, as pessoas com deficiência visual para a afirmação esclarecida dos seus direitos e por outro, os profissionais e organizações sobre o impacto da deficiência visual nas dimensões interpessoais e na autogestão das informações.Palavras-chave: Informação acessível. Comunicação acessível. Literacia em saúde. Cuidados de saúde primários. Pessoas com deficiência visual.Visually impaired people's outlook on primary health care informationABSTRACTConsidering the rights of people with visual impairment and the need for the environment to adapt to the diversity of people, it is intended to understand the extent to which health centres of Portugal respond to communication and interaction needs of people with visual impairment when they access to primary health care. The data collected in this exploratory-descriptive study resulted from a questionnaire survey, by 124 people with visual impairment. It is possible to conclude that health centers do not meet the needs of the majority of participants, and the consequences of this fact are the loss of autonomy, privacy and important information, besides also being perceived some barriers related to interpersonal issues. The results reinforce the importance of awareness of people with visual impairment to their rights and, on the other hand, professionals and organizations about the impact of visual impairment on interpersonal dimensions and self-management of information.Keywords: Accessible information. Accessible communication. Health literacy. Primary health care. Visually impaired people.

scholarly journals Modifying the PACIC to assess provision of chronic illness care: An exploratory study with primary health care nurses

2010 ◽  
Vol 2 (2) ◽  
pp. 118 ◽  
Author(s):  
Jenny Carryer ◽  
Claire Budge ◽  
Chiquita Hansen ◽  
Katherine Gibbs
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Illness ◽  
Care Delivery ◽  
Self Management ◽  
Chronic Illness Care ◽  
Management Support ◽  
Primary Health ◽  
Health Practitioners ◽  
Primary Health Care Nurses

INTRODUCTION: In line with Wagner’s Chronic Care Model, the Patient Assessment of Chronic Illness Care (PACIC) has been developed to evaluate chronic illness care delivery from the patient's perspective. Modification of the instrument to assess the same aspects of care delivery from the health practitioner’s perspective would enable individual practitioners to evaluate their own provision of self-management support, and would also enable a more direct comparison between care provided and care received within the chronic illness context. AIM: To explore the potential of a modified PACIC instrument to assess individual health practitioners’ delivery of care to chronic illness patients with a sample of primary health care nurses. METHODS: Seventy-seven primary care nurses completed the modified PACIC, reworded to ask about care provision rather than receipt of care. An additional seven cultural sensitivity items were included, as were questions about the suitability of the types of chronic illness care and who should be providing the care. RESULTS: The modified PACIC items appear to be appropriate for use with health practitioners. Agreement that the types of care described in the PACIC should be provided was almost unanimous, and the predominant view was that self-management support should be provided by both nurses and doctors. Mean scale scores were higher than those generally reported from studies using the PACIC. DISCUSSION: The results of this first evaluation of a modified PACIC suggest that the original items plus the cultural sensitivity items can be used to assess self-management support by individual health practitioners. KEYWORDS: Chronic illness; self-management; primary health care, nurses

scholarly journals “Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care

2020 ◽  
Author(s):  
Joel Freilich ◽  
Gunnar Nilsson ◽  
Mirjam Ekstedt ◽  
Maria Flink
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Registered Nurses ◽  
Family Caregivers ◽  
Urban Areas ◽  
Common Ground ◽  
Self Management ◽  
Main Theme ◽  
Management Support ◽  
Primary Health

Abstract Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management. Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis. Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.

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