Delineating the concept of self-management in chronic conditions: a concept analysis

Abstract

ObjectivesSelf-management is a concept frequently used within healthcare but lacks consensus. It is the aim of this study to clarify the concept.DesignConcept analysis according to Walker and Avant, comprises eight steps: select concept, determine purpose, identify uses, determine defining attributes, identify model case, identify additional cases, identify antecedents and consequences and define empirical referents. Sources used: PubMed, Scopus and Web of Science.ResultsTen attributes delineating the concept have been identified and organised into three groups. Group (a): person-oriented attributes: the person must (1) actively take part in the care process, (2) take responsibility for the care process and (3) have a positive way of coping with adversity. Group (b): person-environment-oriented attributes: (4) the person must be informed about the condition, disease and treatment and self-management, (5) should be individualised, which entails expressing needs, values and priorities, (6) requires openness to ensure a reciprocal partnership with healthcare providers and (7) demands openness to social support. Finally, Group (c): summarising attributes: self-management (8) is a lifetime task, (9) assumes personal skills and (10) encompasses the medical, role and emotional management.ConclusionsThe findings of this study recognise the complexity of the concept, but also show the need for further investigation to make the concept more measurable. Clarity about the concept will enhance understanding and facilitate implementation in self-management programmes for chronic conditions.

I don’t want to think about it: a qualitative study of children (6 -18 years) with rheumatic diseases and parents' experiences with regular needle injections at home

“…Regular injections comprise more than a little needle stick Short hospital stays are currently the standard for most children with chronic pediatric diseases, as the health care system focuses on self-management outside institutions (20). However, parents in this study felt overwhelmed by their responsibility for the daily treatment, which included technical and emotional challenges related to the injections.…”

Protocol for development, calibration and validation of the Patient-Reported Inventory of Self-Management of Chronic Conditions (PRISM-CC)

“…5 It includes making decisions, taking action and altering behaviours in the context of living every day. [6][7][8] Learning to selfmanage is not a one-time event. It is a lifelong process because chronic conditions, and life itself, fluctuate and change over time.…”

“…It is a lifelong process because chronic conditions, and life itself, fluctuate and change over time. [8][9][10][11][12] Assessing and measuring patients' difficulty self-managing their condition(s) are thus critical to quality healthcare and related research. While many patient-reported measures of self-management have been developed, none has emerged as the gold standard, and all have major limitations: (1) failure to measure the different domains of self-management important to patients, (2) lack of sufficient specificity to support patient-centred care or identify the specific components of selfmanagement interventions that work, and/…”

A Metodologia Da Teoria Fundamentada Nos Dados Construtivista: Considerações Sobre Seu Uso Na Área De Enfermagem Em Cuidados Com Feridas Crônicas

“…Pesquisadores e clínicos concordam que os resultados positivos do diabetes são fortemente influenciados pela implementações de autocuidado diários pelos pacientes. Mas, para isso, os mesmos devem obter conhecimento sobre sua doença, possuírem auto-confiança, serem capazes e suficientemente responsáveis para cuidarem de si mesmos para evitar sérias consequências pela falta de cuidado (Van de Velde et al, 2019). Quais resultados podem ser obtidos com o envolvimento ativo dos pacientes no autocuidados?…”