How does it feel to be a problem? Patients' experiences of self-management support in New Zealand and Canada.

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dc.citation.issue1
dc.citation.volume22
dc.contributor.authorSheridan NF
dc.contributor.authorKenealy TW
dc.contributor.authorFitzgerald AC
dc.contributor.authorKuluski K
dc.contributor.authorDunham A
dc.contributor.authorMcKillop AM
dc.contributor.authorPeckham A
dc.contributor.authorGill A
dc.date.available2019-02
dc.date.available2018-07-13
dc.date.issued22/09/2018
dc.descriptionPublished source must be acknowledged
dc.description.abstractBACKGROUND: The impact of long-term conditions is the "healthcare equivalent to climate change." People with long-term conditions often feel they are a problem, a burden to themselves, their family and friends. Providers struggle to support patients to self-manage. The Practical Reviews in Self-Management Support (PRISMS) taxonomy lists what provider actions might support patient self-management. OBJECTIVE: To offer providers advice on how to support patient self-management. DESIGN: Semi-structured interviews with 40 patient-participants. SETTING AND PARTICIPANTS: Three case studies of primary health-care organizations in New Zealand and Canada serving diverse populations. Participants were older adults with long-term conditions who needed support to live in the community. MAIN OUTCOME MEASURES: Qualitative description to classify patient narratives of self-management support according to the PRISMS taxonomy with thematic analysis to explore how support was acceptable and effective. RESULTS: Patients identified a relationship-in-action as the mechanism, the how by which providers supported them to self-manage. When providers acted upon knowledge of patient lives and priorities, these patients were often willing to try activities or medications they had resisted in the past. Effective self-management support saw PRISMS components delivered in patient-specific combinations by individual providers or teams. DISCUSSION AND CONCLUSIONS: Providers who establish relationships with patients can support them to self-manage and improve health outcomes. Delivery of taxonomy components, in the absence of a relationship, is unlikely to be either acceptable or effective. Providers need to be aware that social determinants of health can constrain patients' options to self-manage.
dc.description.publication-statusPublished
dc.format.extent34 - 45
dc.identifierhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000457461400004&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=c5bb3b2499afac691c2e3c1a83ef6fef
dc.identifier.citationHEALTH EXPECTATIONS, 2019, 22 (1), pp. 34 - 45
dc.identifier.doi10.1111/hex.12823
dc.identifier.eissn1369-7625
dc.identifier.elements-id416171
dc.identifier.harvestedMassey_Dark
dc.identifier.issn1369-6513
dc.identifier.urihttps://hdl.handle.net/10179/16011
dc.publisherJohn Wiley and Sons Limited
dc.relation.isPartOfHEALTH EXPECTATIONS
dc.subjectethnic minorities
dc.subjectlong-term conditions
dc.subjectpatient preferences
dc.subjectpatient-clinician relationship
dc.subjectPRISMS taxonomy
dc.subjectself-management support
dc.subject.anzsrc1110 Nursing
dc.subject.anzsrc1117 Public Health and Health Services
dc.subject.anzsrc1701 Psychology
dc.titleHow does it feel to be a problem? Patients' experiences of self-management support in New Zealand and Canada.
dc.typeJournal article
pubs.notesNot known
pubs.organisational-group/Massey University
pubs.organisational-group/Massey University/College of Health
pubs.organisational-group/Massey University/College of Health/PVC's Office - College of Health
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