Self-management support activities in primary care: A qualitative study to compare provision across common health problems |
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| Affiliation: | 1. School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;2. South West Yorkshire Partnership NHS Foundation Trust, Wakefield, UK;3. Research and Development, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, UK;1. School of Nursing, Johns Hopkins University, Baltimore, MD USA;2. School of Medicine (General Internal Medicine), Bloomberg School of Public Health, and Carey School of Business Johns Hopkins University, Baltimore, MD USA;1. Department of Nursing, Yuanlin Christian Hospital, Changhua, Taiwan;2. Center for Evidence-Based Health Care, Department of Medical Research, Taipei Medical University Shuang Ho Hospital, Zhonghe District, New Taipei City, Taiwan;3. Shared Decision Making Resource Center, Department of Medical Research, Taipei Medical University Shuang Ho Hospital, New Taipei City, Taiwan;4. Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;5. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan;6. School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan;1. Department of Kinesiology and Public Health Education, University of North Dakota, 2751 2nd Avenue North, Stop 8235, Grand Forks, ND 58202, USA;2. Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences & Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia;3. Defence Science and Technology Group (DSTG), 506 Lorimer Street, Port Melbourne, VIC 3207, Australia;1. School of Engineering and the Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK;2. Property and Facilities Management, Resources, The City of Edinburgh Council, Level 1.4, Waverley Court, 4 East Market Street, Edinburgh, EH8 8BG, UK;3. 30 North Fort Street, Edinburgh, EH6 4HD, UK;4. Energy Action Scotland, Suite 4a Ingram House, 227 Ingram Street, Glasgow, G1 1DA, UK;1. National Cancer Registry Ireland, Kinsale Road, Cork, Ireland;2. Department of Behavioural Science and Health, University College London, London, UK;3. School of Psychology, Dublin City University, Dublin, Ireland;4. College of Medicine Nursing & Health Sciences, National University of Ireland Galway, Ireland;5. Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Dublin, Ireland;6. Cork University Dental School and Hospital, Cork, Ireland;7. St. James’s Hospital, James’s Street, Dublin, Ireland;8. Department of Histopathology, University of Dublin, Trinity College, Ireland;9. Department of Pathology, Coombe Women and Infants University Hospital, Ireland;10. Institute of Health & Society, Newcastle University, UK;1. School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK;2. Department of Health Sciences and the Hull York Medical School, University of York, York, UK |
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| Abstract: | ObjectiveTo explore the views of primary care teams about the provision of self-management support to patients with common health problems.MethodsSemi-structured interviews were conducted with twenty-one members of the primary care team from thirteen general practices. Interviews were transcribed verbatim, and analysed using the ‘Framework’ approach.ResultsThree categories and six sub-categories illustrating different self-management support activities across common health problems were identified from the analysis of interviews, and contributed to one major theme and one cross-cutting theme. Referral and signposting were frequently used to facilitate patient engagement with external services and resources. Practitioners faced some challenges in balancing medical management and psychosocial support and motivating patients to engage with self-management.ConclusionsPrimary care teams described providing a wide range of self-management support activities, but the pattern of use varied for different types of health problem. These patterns may have been influenced, in part, by general practices focusing upon achieving financially incentivised quality improvement goals.Practice implicationsTo improve self-management support, practitioners need a digital repository of services/resources, motivational interviewing skills, an understanding of the optimum duration and pattern of consultations, and incentivised targets that match a biopsychosocial model of care. |
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| Keywords: | Chronic disease General practice Long-term conditions Medically unexplained symptoms Mental health Primary health care Qualitative Self-care Self-management Self-management support |
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