Self-management support activities in primary care: A qualitative study to compare provision across common health problems

Harris, Emma; Barker, Caroline; Burton, Kim; Lucock, Mike; Astin, Felicity

doi:10.1016/j.pec.2020.07.003

Cited by 7 publications

(4 citation statements)

References 37 publications

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“…Several qualitative studies address the nurse-person relationship as the focus of SMS. According to Harris et al [ 73 ], a quality relationship based on mutual trust facilitates individualization of the SMS, communication, engagement, and would increase the person’s willingness to consider the nurse’s advice. In a qualitative study exploring how SMS should be applied in a multimorbidity clientele [ 74 ], the presence of a trusting relationship; an individualized SMS “by taking the patient’s agenda into account” (p. 6); relational continuity; and support “that went beyond information and disease management” (p. 6) are important elements.…”

Section: Discussionmentioning

confidence: 99%

“…Central to several models of person-centered and integrative approaches [ 27 , 80 – 83 ], the biopsychosocial perspective is another defining feature of the integrated SMS, as it allows for the management of all health issues. However, it seems more difficult to apply a biopsychosocial SMS to each session and a few reasons may explain this: a lack of expertise in the field of psychosocial support and mental health; administrative priorities (e.g., data collection, funding) favoring physical CD; short encounters limiting holistic management; and predominantly biomedical clinical targets [ 23 , 73 , 74 ]. To improve the biopsychosocial approach and the clinical integration of SMS, the reviewed studies made several recommendations to enhance nurses’ training on the biopsychosocial approach [ 41 , 44 ], patient engagement [ 41 ], behavioral change management and behavioral activation [ 41 , 56 ], motivational interviewing [ 41 , 44 , 58 ], psychosocial support [ 41 , 57 ], anxiety [ 57 ], and listening [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

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Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a scoping review

et al. 2022

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Aim To map integrated and non-integrated self-management support interventions provided by primary care nurses to persons with chronic diseases and common mental disorders and describe their characteristics. Design A scoping review. Data sources In April 2020, we conducted searches in several databases (Academic Research Complete, AMED, CINAHL, ERIC, MEDLINE, PsycINFO, Scopus, Emcare, HealthSTAR, Proquest Central) using self-management support, nurse, primary care and their related terms. Of the resulting 4241 articles, 30 were included into the analysis. Review methods We used the Rainbow Model of Integrated Care to identify integrated self-management interventions and to analyze the data and the PRISMS taxonomy for the description of interventions. Study selection and data synthesis were performed by the team. Self-management support interventions were considered integrated if they were consistent with the Rainbow model’s definition of clinical integration and person-focused care. Results The 30 selected articles related to 10 self-management support interventions. Among these, five interventions were considered integrated. The delivery of the interventions showed variability. Strategies used were education, problem-solving therapies, action planning, and goal setting. Integrated self-management support intervention characteristics were nurse-person relationship, engagement, and biopsychosocial approach. A framework for integrated self-management was proposed. The main characteristics of the non-integrated self-management support were disease-specific approach, protocol-driven, and lack of adaptability. Conclusion Our review synthesizes integrated and non-integrated self-management support interventions and their characteristics. We propose recommendations to improve its clinical integration. However, further theoretical clarification and qualitative research are needed. Implication for nursing Self-management support is an important activity for primary care nurses and persons with chronic diseases and common mental disorders, who are increasingly present in primary care, and require an integrated approach. Impact This review addresses the paucity of details surrounding integrated self-management support for persons with chronic diseases and common mental disorders and provides a framework to better describe its characteristics. The findings could be used to design future research and improve the clinical integration of this activity by nurses.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a scoping review

et al. 2022

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“…Support was provided by Link Workers (4 or 5 variously during the evaluation) based within GP practices and other locations including community centres. Access was by referral or signposting, defined by Harris et al (2020), respectively, as ‘connecting’ and ‘directing’, and by self‐referral. A referral is a formal, practitioner‐led process of linking individuals to services; signposting involves practitioners providing information, with the process of contacting the service (self‐referral) undertaken by the individual; the latter requires less work for practitioners but makes greater demands on individuals (Carstairs et al, 2020; Harris et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Access was by referral or signposting, defined by Harris et al (2020), respectively, as ‘connecting’ and ‘directing’, and by self‐referral. A referral is a formal, practitioner‐led process of linking individuals to services; signposting involves practitioners providing information, with the process of contacting the service (self‐referral) undertaken by the individual; the latter requires less work for practitioners but makes greater demands on individuals (Carstairs et al, 2020; Harris et al, 2020). The service aimed to work closely with GPs, but other health and social care practitioners and VCS workers could also refer/signpost.…”

Section: Introductionmentioning

confidence: 99%

More than signposting: Findings from an evaluation of a social prescribing service

White

Bell

Reid

et al. 2022

Health Social Care Comm

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This paper presents findings from an evaluation of a social prescribing service, undertaken between January 2019 and December 2020. Data was collected through interviews and focus groups with a range of groups including social prescribing managers, link workers (LWs), referrers (GPs and social work practitioners), clients, Voluntary and Community Sector (VCS) agencies and groups. Thematic analysis of data was undertaken, and findings were presented in respect of clients' journeys into social prescribing; the support received from LWs; their onward journeys to VCS support. The findings highlight the challenges for individuals in contacting new agencies/groups and the importance of practitioner referral into and onwards from social prescribing, as well as buddying to support clients on initial agency visits. The depth of the LW role is highlighted, as well as the complexity of client circumstances, highlighting a need for ‘more than signposting’, and challenging the notion of self‐referral as an indicator of motivation. Social prescribing has been positioned as amongst the solutions to the challenges of primary care. However, referrals from GPs were low and significantly outnumbered by those from social workers; this suggests a need to explore in greater depth the use of social prescribing by social workers, who have, to date, been absent from social prescribing research.

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Verpleegkundige competenties voor zelfmanagementondersteuning

Becqué¹,

Hooft²,

Dwarswaard³

2023

Verpleegkundige Ondersteuning Bij Zelfmanagement en Eigen Regie

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Self-management support activities in primary care: A qualitative study to compare provision across common health problems

Abstract: Self-management support activities in primary care: a qualitative study to compare provision across common health problems.

Cited by 7 publications

References 37 publications

Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a scoping review

Integrated self-management support provided by primary care nurses to persons with chronic diseases and common mental disorders: a scoping review

More than signposting: Findings from an evaluation of a social prescribing service

Verpleegkundige competenties voor zelfmanagementondersteuning

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