The over time development of chronic illness self-management patterns: a longitudinal qualitative study

Abstract

BackgroundThere currently exists a vast amount of literature concerning chronic illness self-management, however the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time.MethodTwenty-one individuals newly diagnosed with chronic illnesses (e.g., diabetes, rheumatism, ischemic heart disease, multiple sclerosis, chronic renal disease, inflammatory bowel disease) were repeatedly interviewed over two-and-a-half years. The interviews were conducted in Sweden from 2006 to 2008. A total of 81 narrative interviews were analyzed with an interpretive description approach.ResultsThe participants’ self-management behaviors could be described in four different developmental patterns: consistent, episodic, on demand, and transitional. The developmental patterns were related to specific self-management behaviors. Most participants took long-term medications in a consistent pattern, whereas exercise was often performed according to an episodic pattern. Participants managed health crises (e.g., angina, pain episodes) according to an on demand pattern and everyday changes due to illness (e.g., adaptation of work and household activities) according to a transitional pattern. All of the participants used more than one self-management pattern.ConclusionThe findings show that self-management does not develop as one uniform pattern. Instead different self-management behaviors are enacted in different patterns. Therefore, it is likely that self-management activities require support strategies tailored to each behavior’s developmental pattern.

Physical activity and exercise training in multiple sclerosis: a review and content analysis of qualitative research identifying perceived determinants and consequences

“…occupation [55] or parenting [56]). Four studies had a small component on physical activity, yet the focus was actually on the wider issues surrounding those with MS [57][58][59][60]. Six studies had a small component related to physical activity or exercise, but the primary focus was on understanding [27,28] studies were reviewed.…”

Self-care of young people with long-term physical and mental health conditions

“…This will be based on two studies that we have conducted that involved systematic reviews and empirical research (Kendal et al 2016;Kirk and Milnes, 2015;Kirk et al 2010;, 2013Pryjmachuk et al 2014). In this paper we summarise and synthesise the findings from these studies.…”

“…Furthermore it has been noted that professionals' understandings of self-care and self-management are based on a model of compliance rather than empowerment (Sawyer and Aroni 2005;Sadler et al 2014;Dwarswaard et al 2015). A common criticism is that self-care and self-management tend to focus on the individual and changing their behaviour; neglecting not only their social context and lay understandings of long-term illness but also the influence and roles played by families and social networks (Rosland and Piette 2010;Audulv 2013;Ong et al 2014;Sadler et al 2014;Dwarswaard et al 2015;Miller et al 2015). This is particularly pertinent in relation to children/young people as parents play an important role in self-management/care and peers exert an influence over beliefs and behaviours.…”

An integrative review of drug utilization by the elderly in primary health care

“…Measuring blood pressure at home improved the relationship between patients and professionals, as they started discussing the values observed during medical visits (16,(71)(72) . Generally speaking, when people are diagnosed with a chronic disease, they develop new behaviors to manage their health, including taking drugs correctly and adopting healthy habits to take care of their health (73) . However, sometimes accepting living with a permanent condition is not as simple as the literature describes.…”