The Individual and Family Self-Management Theory: Background and perspectives on context, process, and outcomes

Abstract

Current evidence indicates that individuals and families who engage in self-management (SM) behaviors improve their health outcomes. While the results of these studies are promising, there is little agreement as to the critical components of SM or directions for future study. This paper offers an organized perspective of similar and divergent ideas related to SM. Unique contributions of prior work are highlighted and findings from studies are summarized. A new descriptive midrange theory, Individual and Family Self-management Theory, is presented; assumptions identified, concepts defined, and proposed relationships outlined. This theory adds to the literature on self-management by focusing on individual, dyads within the family, or the family unit as a whole; explicating process components of self-management; and proposing use of proximal and distal outcomes.The need to manage chronic conditions and to actively engage in a lifestyle that fosters health is increasingly recognized as the responsibility of the individual and their family. Health problems have shifted from acute to chronic and personal behaviors are linked to over half of chronic health problems. 1,2 Health care delivery has shifted to non-hospital venues with hospitalizations often eliminated or shortened. Criteria for hospital discharge are related to outcomes of conditions or procedures rather than the ability of patients or families to manage care. 1 It is estimated that half of all Americans are managing a serious chronic health condition at home. Over 12% of children have special health care needs and 23% of these children are significantly impacted by their condition. 3 In adults, 7% of persons between the ages of 45 and 54 and 37% of person over the age of 75 are managing three chronic conditions. 1 While the values of health promotion are increasingly realized for individuals and families, few health-promoting strategies are routinely incorporated into the delivery of health care in many settings. Individuals and families are expected to sort through the myriad of contradictory health information of varying quality and engage in behaviors promoting their health. Personal efforts to engage in healthy behaviors are often Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptNurs Outlook. Author manuscript; available in PMC 2010 July 23. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript derailed by social factors incongruent with health, 1, 4 such as neighborhoods unsafe for exercise, peer-group norms related to food choices and alcohol, and ...

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