Understanding beneficial self-management support and the meaning of user involvement in lifestyle interventions: a qualitative study from the perspective of healthcare professionals

ObjectivesTo support the adaptation and translation of an evidence-based chronic kidney disease (CKD) self-management intervention to the Chinese context, we examined the beliefs, perceptions and needs of Chinese patients with CKD and healthcare professionals (HCPs) towards CKD self-management.DesignA basic interpretive, cross-sectional qualitative study comprising semistructured interviews and observations.SettingOne major tertiary referral hospital in Henan province, China.Participants11 adults with a diagnosis of CKD with CKD stages G1–G5 and 10 HCPs who worked in the Department of Nephrology.ResultsFour themes emerged: (1) CKD illness perceptions, (2) understanding of and motivation towards CKD self-management, (3) current CKD practice and (4) barriers, (anticipated) facilitators and needs towards CKD self-management. Most patients and HCPs solely mentioned medical management of CKD, and self-management was largely unknown or misinterpreted as adherence to medical treatment. Also, the majority of patients only mentioned performing disease-specific acts of control and not, for instance, behaviour for coping with emotional problems. A paternalistic patient–HCP relationship was often present. Finally, the barriers, facilitators and needs towards CKD self-management were frequently related to knowledge and environmental context and resources.ConclusionsThe limited understanding of CKD self-management, as observed, underlines the need for educational efforts on the use and benefits of self-management before intervention implementation. Also, specific characteristics and needs within the Chinese context need to guide the development or tailoring of CKD self-management interventions. Emphasis should be placed on role management and emotional coping skills, while self-management components should be tailored by addressing the existing paternalistic patient–HCP relationship. The use of electronic health innovations can be an essential facilitator for implementation.

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Participants and developers experiences with a chronic pain self-management intervention under development: A qualitative study

SAGE Open Medicine ◽

10.1177/2050312118817427 ◽

2018 ◽

Vol 6 ◽

pp. 205031211881742 ◽

Cited By ~ 1

Author(s):

Kjersti Grønning ◽

Torunn Hatlen Nøst ◽

Toril Rannestad ◽

Ola Bratås

Keyword(s):

Chronic Pain ◽

Qualitative Study ◽

Behavioural Change ◽

User Involvement ◽

Social Needs ◽

Self Management ◽

Pharmacological Interventions ◽

Healthy Life ◽

Management Intervention ◽

Cognitive Techniques

Background: Non-pharmacological interventions aim to promote health and self-management for people with chronic pain. Objective: The aim of this study was to explore if the participants’ experiences with a self-management intervention under development were aligned with the developers’ rationale and desired outcome of the intervention. Methods: This was a qualitative study interviewing both participants and developers of a chronic pain self-management intervention. Seven participants, six females and one male in the age from early thirties to mid-seventies attended the chronic pain self-management intervention developed by the staff at a Healthy Life Centre. The data were analysed by the systematic text condensation method. Results: The analyses showed that the participants evaluated the intervention as valuable. They described using coping techniques to manage their chronic pain better, and the developers stated that the aim with the intervention was to provide the participants with coping techniques. The intervention was built upon the developers’ professional knowledge and experience in cognitive techniques, health theories, models for behavioural change, and service user involvement. Conclusion: This study found that the chronic pain self-management intervention was in concordance with theory of health promotion and empowerment. The participants experienced the intervention as targeting their resources, capacities, and fulfilling social needs, which aligned with the developers aim with the intervention. The participants found the intervention evocative; they learned new ways to manage their pain through theory/education, movement exercises, homework, and sharing their experiences with each other.

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Building Bridges between healthcare professionals, patients and families: A coproduced and integrated approach to self-management support in stroke

Neurorehabilitation ◽

10.3233/nre-161379 ◽

2016 ◽

Vol 39 (4) ◽

pp. 471-480 ◽

Cited By ~ 10

Author(s):

Fiona Jones ◽

Heide Pöstges ◽

Lucinda Brimicombe

Keyword(s):

Healthcare Professionals ◽

Integrated Approach ◽

Self Management ◽

Management Support

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Goal setting in group programmes for long-term condition self-management support: experiences of patients and healthcare professionals

Psychology and Health ◽

10.1080/08870446.2019.1623891 ◽

2019 ◽

Vol 35 (1) ◽

pp. 70-86 ◽

Cited By ~ 3

Author(s):

Stephen Hughes ◽

Sophie Lewis ◽

Karen Willis ◽

Anne Rogers ◽

Sally Wyke ◽

...

Keyword(s):

Goal Setting ◽

Healthcare Professionals ◽

Self Management ◽

Management Support ◽

Term Condition

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Self-management support preferences of people with asthma or chronic obstructive pulmonary disease: A systematic review and meta-synthesis of qualitative studies

Chronic Illness ◽

10.1177/1742395319869443 ◽

2019 ◽

pp. 174239531986944 ◽

Cited By ~ 3

Author(s):

Selena O’Connell ◽

Vera JC McCarthy ◽

Eileen Savage

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Pulmonary Disease ◽

Healthcare Professionals ◽

Qualitative Studies ◽

Self Management ◽

Chronic Obstructive ◽

Management Support ◽

Obstructive Pulmonary Disease ◽

The Individual ◽

Behavioural Sciences

Objectives To synthesise findings from qualitative studies on the preferences of people with asthma or chronic obstructive pulmonary disease (COPD) for self-management support. Methods A thematic synthesis of literature was carried out. Six databases (ASSIA, CINAHL, MEDLINE, PsycINFO, Psychology and the Behavioural Sciences and SSCI) were used to search for qualitative studies eliciting perspectives of adults with asthma and/or COPD on self-management support, published between May 2008 and April 2018. Results A total of 968 articles were retrieved across databases, with 15 articles included in the synthesis. Three themes were identified: Types of Support described the range of supports valued by participants in the studies, particularly education provided by competent healthcare professionals; The Support Relationship highlighted the importance of a collaborative relationship with one’s healthcare professional which was characterised by communication, trust and continuity over time and Accessibility identified the considerations of participants relating to physically accessible, prompt support which is provided in a format preferred by the individual. Discussion Increased understanding of patients’ preferences may provide insight which can be used to enhance engagement with self-management support. Further research needs to examine self-management support preferences outside the context of evaluating interventions for people with asthma/COPD and needs to address the optimal means of enhancing accessibility.

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The impact of COVID-19 on chronic care according to providers: a qualitative study among primary care practices in Belgium

BMC Family Practice ◽

10.1186/s12875-020-01326-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Katrien Danhieux ◽

Veerle Buffel ◽

Anthony Pairon ◽

Asma Benkheil ◽

Roy Remmen ◽

...

Keyword(s):

Primary Care ◽

High Risk ◽

Qualitative Study ◽

Chronic Care ◽

Self Management ◽

Management Support ◽

High Risk Patients ◽

Risk Patients ◽

Care Practices ◽

Primary Care Practices

Abstract Background The COVID-19 pandemic affects the processes of routine care for chronic patients. A better understanding helps to increase resilience of the health system and prepare adequately for next waves of the pandemic. Methods A qualitative study was conducted in 16 primary care practices: 6 solo working, 4 monodisciplinary and 7 multidisciplinary. Twenty-one people (doctors, nurses, dieticians) were interviewed, using semi-structured video interviews. A thematic analysis was done using the domains of the Chronic Care Model (CCM). Results Three themes emerged: changes in health care organization, risk stratification and self-management support. All participating practices reported drastic changes in organization with a collective shift towards COVID-19 care, and reduction of chronic care activities, less consultations, and staff responsible for self-management support put on hold. A transition to digital support did not occur. Few practitioners had a systematic approach to identify and contact high-risk patients for early follow-up. A practice with a pre-established structured team collaboration managed to continue most chronic care elements. Generally, practitioners expected no effects of the temporary disruption for patients, although they expressed concern about patients already poorly regulated. Conclusion Our findings show a disruption of the delivery of chronic care in the Belgium prim care context. In such contexts, the establishment of the CCM can facilitate continuity of care in crisis times. Short term actions should be directed to facilitate identifying high-risk patients and to develop a practice organization plan to organize chronic care and use digital channels for support, especially to vulnerable patients, during next waves of the epidemic.

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Community nurses' self‐management support in older adults: A qualitative study on views, dilemmas and strategies

Health & Social Care in the Community ◽

10.1111/hsc.12853 ◽

2019 ◽

Vol 28 (1) ◽

pp. 195-203

Author(s):

Marian J. T. Bolscher‐Niehuis ◽

Madeleen J. Uitdehaag ◽

Anneke L. Francke

Keyword(s):

Older Adults ◽

Qualitative Study ◽

Self Management ◽

Management Support

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Self-management of patients with advanced cancer: A systematic review of experiences and attitudes

Palliative Medicine ◽

10.1177/0269216319883976 ◽

2020 ◽

Vol 34 (2) ◽

pp. 160-178 ◽

Cited By ~ 2

Author(s):

Sophie I van Dongen ◽

Kim de Nooijer ◽

Jane M Cramm ◽

Anneke L Francke ◽

Wendy H Oldenmenger ◽

...

Keyword(s):

Systematic Review ◽

Advanced Cancer ◽

Healthcare Professionals ◽

Management Strategies ◽

Personal Characteristics ◽

Qualitative Studies ◽

Medical Decision ◽

Self Management ◽

Management Support ◽

Quality Of Reporting

Background: Patients with advanced cancer are increasingly expected to self-manage. Thus far, this topic has received little systematic attention. Aim: To summarise studies describing self-management strategies of patients with advanced cancer and associated experiences and personal characteristics. Also, to summarise attitudes of relatives and healthcare professionals towards patient self-management. Design: A systematic review including non-experimental quantitative and qualitative studies. Data were analysed using critical interpretive synthesis. Included studies were appraised on methodological quality and quality of reporting. Data sources: MEDLINE, Embase, Cochrane Central, PsycINFO, CINAHL, Web of Science and Google Scholar (until 11 June 2019). Results: Of 1742 identified articles, 31 moderate-quality articles describing 8 quantitative and 23 qualitative studies were included. Patients with advanced cancer used self-management strategies in seven domains: medicine and pharmacology, lifestyle, mental health, social support, knowledge and information, navigation and coordination and medical decision-making (29 articles). Strategies were highly individual, sometimes ambivalent and dependent on social interactions. Older patients and patients with more depressive symptoms and lower levels of physical functioning, education and self-efficacy might have more difficulties with certain self-management strategies (six articles). Healthcare professionals perceived self-management as desirable and achievable if based on sufficient skills and knowledge and solid patient–professional partnerships (three articles). Conclusion: Self-management of patients with advanced cancer is highly personal and multifaceted. Strategies may be substitutional, additional or even conflicting compared to care provided by healthcare professionals. Self-management support can benefit from an individualised approach embedded in solid partnerships with relatives and healthcare professionals.

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Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis

Chronic Illness ◽

10.1177/1742395317710082 ◽

2017 ◽

Vol 14 (2) ◽

pp. 79-103 ◽

Cited By ~ 24

Author(s):

Marika Franklin ◽

Sophie Lewis ◽

Karen Willis ◽

Helen Bourke-Taylor ◽

Lorraine Smith

Keyword(s):

Systematic Review ◽

Healthcare Professionals ◽

Care Delivery ◽

Individual Responsibility ◽

Self Management ◽

Chronic Obstructive ◽

Traditional Model ◽

Management Support ◽

Model Of Care ◽

Qualitative Synthesis

Objective To review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions. Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004–2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient–provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria. Results Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients’ responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes ‘effective’ self-management. Discussion Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.

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