Supporting chronic disease self-management: translating policies and principles into clinical practice

2012 ◽  
Vol 18 (1) ◽  
pp. 80 ◽  
Author(s):  
Rosemary Higgins ◽  
Barbara Murphy ◽  
Marian Worcester ◽  
Angela Daffey
Keyword(s):  
Chronic Disease ◽  
Health Professionals ◽  
Health Workers ◽  
Aboriginal Health ◽  
Practice Change ◽  
Self Management ◽  
Collaborative Approach ◽  
Allied Health Professionals ◽  
Major Barrier ◽  
Training Support

To support self-management, health professionals need to adopt a client-centred approach and learn to deliver evidence-based behaviour change interventions. This paper reports on the evaluation of 1- and 2-day training programs developed to improve health professionals’ capacity to support chronic disease self-management (CDSM). The 321 participants attended one of eighteen supporting CDSM courses held in urban and rural settings. Participants included nurses, allied health professionals, Aboriginal health workers and general practitioners. Data were collected at three time points: before participation; immediately after the training; and, for a sub-sample of 37 participants, 2 months after the training. Results revealed a significant and sustained increase in CDSM self-efficacy following training regardless of participants’ gender, age or qualifications. A thematic analysis of the responses concerning intended practice revealed four main areas of intended practice change, namely: use behavioural strategies; improve communication with clients; adopt a client-centred approach; and improve goal setting. The number of practice changes at 2 months reported by a sub-sample of participants ranged from 1 to 20 with a mean of 14 (s.d. = 4). The three most common areas of practice change point to the adoption by health professionals of a collaborative approach with chronic disease patients. Lack of staff trained in CDSM was seen as a major barrier to practice change, with lack of support and finance also named as barriers to practice change. Participants identified that increased training, support and awareness of the principles of supporting CDSM would help to overcome barriers to practice change. These results indicate a readiness among health professionals to adopt a more collaborative approach given the skills and the tools to put this approach into practice.

scholarly journals Chronic disease self-management in Aboriginal Communities: Towards a sustainable program of care in rural communities

2003 ◽  
Vol 9 (3) ◽  
pp. 168 ◽  
Author(s):  
J Ah Kit ◽  
C Prideau x ◽  
PW Harve y ◽  
J Collin s ◽  
M Battersb y ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Illness ◽  
Goal Setting ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Self Management ◽  
Pilot Program ◽  
Aboriginal Communities ◽  
One Year

The Chronic Disease Self-Management (CDSM) strategy for Aboriginal patients on Eyre Peninsula, South Australia, was designed to develop and trial new program tools and processes for goal setting, behaviour change and self-management for Aboriginal people with diabetes. The project was established as a one-year demonstration project to test and trial a range of CDSM processes and procedures within Aboriginal communities and not as a formal research project. Over a one-year period, 60 Aboriginal people with type-2 diabetes in two remote regional centres participated in the pilot program. This represents around 25% of the known Aboriginal diabetic population in these sites. The project included training for four Aboriginal Health Workers in goal setting and self-management strategies in preparation for them to run the program. Patients completed a Diabetes Assessment Tool, a Quality of Life Questionnaire (SF12), the Work and Social Adjustment Scale (WASAS) at 0, 6 and 12 months. The evaluation tools were assessed and revised by consumers and health professionals during the trial to determine the most functional and acceptable processes for Aboriginal patients. Some limited biomedical data were also recorded although this was not the principal purpose of the project. Initial results from the COAG coordinated care trial in Eyre suggest that goal setting and monitoring processes, when modified to be culturally inclusive of Aboriginal people, can be effective strategies for improving self-management skills and health-related behaviours of patients with chronic illness. The CDSM pilot study in Aboriginal communities has led to further refinement of the tools and processes used in chronic illness self-management programs for Aboriginal people and to greater acceptance of these processes in the communities involved. Participation in a diabetes self-management program run by Aboriginal Health Workers assists patients to identify and understand their health problems and develop condition management goals and patient-centred solutions that can lead to improved health and wellbeing for participants. While the development of self-management tools and strategies led to some early indications of improvements in patient participation and resultant health outcomes, the pilot program and the refinement of new assessment tools used to assist this process has been the significant outcome of the project. The CDSM process described here is a valuable strategy for educating and supporting people with chronic conditions and in gaining their participation in programs designed to improve the way they manage their illness. Such work, and the subsequent health outcome research planned for rural regions, will contribute to the development of more comprehensive CDSM programs for Aboriginal communities generally.

Challenges and Benefits of Implementing a Chronic Disease Self-management Program in an Aboriginal Community Controlled Health Setting

2007 ◽  
Vol 13 (3) ◽  
pp. 35 ◽  
Author(s):  
PA Abbott ◽  
JE Davison ◽  
LF Moore
Keyword(s):  
Chronic Disease ◽  
Health Workers ◽  
Aboriginal Health ◽  
Management Program ◽  
Self Management ◽  
Aboriginal Community ◽  
Medical Practitioners ◽  
Health Measures ◽  
Major Benefit ◽  
General Medical Practitioners

The experience of Aboriginal health workers and general medical practitioners at the Aboriginal Medical Service Western Sydney in using patient-centred health measures as a part of chronic disease self-management program is discussed. Challenges encountered were lack of confidence in using these tools, adaptation of the tools without full understanding of their background and adequate testing, and lack of take-up of the care planning component by GPs. Benefits included improved communication between Aboriginal health workers, GPs and patients. The major benefit noted was that Aboriginal health workers felt the tools helped them to understand the barriers their most challenging patients faced to changing their health behaviour. This was motivating and encouraging for Aboriginal health workers, who often provide extensive support-both emotional and practical-to patients with high burdens of chronic disease and self-management difficulties.

Self-management strategies in neurorehabilitation

2020 ◽  
pp. 387-400
Author(s):  
Fiona Jones ◽  
Sara Demain
Keyword(s):  
Decision Making ◽  
Chronic Disease ◽  
Healthcare Professional ◽  
Shared Decision Making ◽  
Management Strategies ◽  
Self Management ◽  
Shared Decision ◽  
Collaborative Approach ◽  
Clinical Encounters ◽  
Measuring Outcomes

This chapter examines self-management in a way that introduces evidence, ideas, and concepts which illustrate the benefits of a personalized collaborative approach to neurorehabilitation. It reviews constructions of self-management from the chronic disease literature and the relevance to neurology and overlapping methods such as shared decision-making, health coaching, and motivational interviewing. It also reviews the benefits of integrating key self-management strategies into clinical encounters and current methods of measuring outcomes. It has been written for any healthcare professional who seeks to understand how to support and enable self-management within neurorehabilitation.

scholarly journals Resilience and associative stigma among mental health professionals in a tertiary psychiatric hospital: a cross-sectional study in Singapore

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033762 ◽  
Author(s):  
Sherilyn Chang ◽  
Louisa Picco ◽  
Edimansyah Abdin ◽  
Qi Yuan ◽  
Siow Ann Chong ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Family Member ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Health Workers ◽  
Close Friend ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Associative Stigma

ObjectivesThe mental health profession exposes healthcare workers to unique stressors such as associative stigma (stigmatisation that is extended from the stigmatised patients to psychiatric professionals and is based on affiliation with an individual with mental illness). Enhancing resilience, or the ability to ‘bounce back’ from adversity, is found to be useful in reducing occupational stress and its negative effects. In view of the high burnout rates reported among mental health professionals, this study aimed to examine resilience in this group of professionals and to explore the association between resilience and associative stigma.DesignObservational study—cross-sectional design.SettingTertiary psychiatry hospital in Singapore.ParticipantsThe study was conducted among 470 mental health professionals (doctors, nurses and allied health professionals) working in the hospital.MeasuresResilience was assessed using the Brief Resilience Scale (BRS) and participants completed questionnaires that examined associative stigma. Participants provided their sociodemographic information, length of service, and information on whether they knew of a close friend or family member who had a mental illness.ResultsMean resilience score for the overall sample was 3.59 (SD=0.64). Older age (β=0.012, 95% CI 0.004 to 0.019, p=0.003) and having known a family member or close friend with a mental illness (β=0.155, 95% CI 0.019 to 0.290, p=0.025) predicted higher BRS score. Associative stigma remained significantly associated with resilience score after controlling for sociodemographic factors whereby higher associative stigma predicted lower resilience scores.ConclusionThe present finding suggests that resilience building programmes among mental health workers should target those of the younger age group, and that addressing the issue of associative stigma is essential.

The chronic disease self-management project at Katherine West Health Board Aboriginal Corporation in the Northern Territory: A report of the first year

2003 ◽  
Vol 9 (3) ◽  
pp. 160 ◽  
Author(s):  
Robyn Mobbs ◽  
Hung The Nguyen ◽  
Andrew Bell
Keyword(s):  
Chronic Disease ◽  
Service Sector ◽  
Community Support ◽  
Aboriginal Health ◽  
Health Service Delivery ◽  
Governance Structure ◽  
Northern Territory ◽  
Self Management ◽  
Health Board ◽  
Local Health

Katherine West Health Board Aboriginal Corporation (KWHB) at Katherine in the Northern Territory is an Aboriginal health service delivery organization directed by the Indigenous Board. The Chronic Disease Self-Management Demonstration Project (CDSM) commenced in April, 2002 at KWHB with funding from the Commonwealth Department of Health and Ageing Sharing Health Care initiative, as one of eight demonstration projects across the country. The project is under the direction of the KWHB Board, which is made up of 18 members elected by their own communities that lie within the KWHB service sector. The full Board or the Board Executive meet routinely throughout each year and members are actively involved with the project at both community and Board levels. The project governance structure also includes a Steering Committee and the Project Management Group that meets monthly. The project is well supported by the various management and administrative sections of KWHB. In the communities, the project reports to the local health committees that have been established by KWHB with community support, and to the local CDSM committees made up of members of the target group.

scholarly journals The use of social media among health professionals to facilitate chronic disease self-management with their patients: A systematic review

2018 ◽  
Vol 4 ◽  
pp. 205520761877141 ◽  
Author(s):  
Gino De Angelis ◽  
George A Wells ◽  
Barbara Davies ◽  
Judy King ◽  
Shirin M Shallwani ◽  
...  
Keyword(s):  
Social Media ◽  
Chronic Disease ◽  
Health Professionals ◽  
Ease Of Use ◽  
Self Management ◽  
Discussion Forums ◽  
Perceived Ease Of Use ◽  
Collaborative Project ◽  
Social Media Platforms ◽  
Use Of Social Media

Objective The objective of this systematic review was to summarize the evidence pertaining to the use of social media by health professionals to facilitate chronic disease self-management with their patients. Methods A systematic approach was used to retrieve and extract relevant data. A total of 5163 citations were identified, of which seven unique studies met criteria for inclusion; one was a randomized controlled trial, two were prospective cohort studies, and four were qualitative studies. The following social media platforms were evaluated: discussion forums (6 studies) and collaborative project (1 study). Results The available evidence suggests that health professionals perceived discussion forums and collaborative projects to be useful social media platforms to facilitate chronic disease self-management with patients. No relevant evidence was found regarding the use of other social media platforms. Most studies indicated positive findings regarding health professionals’ intention to use discussion forums, while the one study that used a collaborative project also indicated positive findings with its perceived ease of use as health professionals felt that it was useful to facilitate chronic disease self-management with patients. Mixed findings were seen in regards to health professionals’ perceived ease of use of discussion forums. The most common barrier to using social media platforms was the lack of time in health professionals’ schedules. Conclusions Discussion forums and collaborative projects appear to be promising resources for health professionals to assist their patients in self-managing their chronic conditions; however, further research comparing various social media platforms is needed.

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