Self-management support

Self-management support is the help given to people with long-term conditions to enable you to manage your health on a day-to-day basis.

undefinedKey points

  1. Self-management support includes regular assessment by your healthcare provider of your problems and progress.
  2. At those sessions, you set goals and learn problem-solving approaches.
  3. You also learn practical skills so you can better manage your long-term condition. 
  4. More self-management support improves your health outcomes and makes it less likely you will end up in hospital. 

What is the definition of self-management support?

Self-management support is defined as the education initiatives and support given by healthcare providers and staff to enable anyone with a long-term condition to increase their skills and confidence in managing their health problems.

Self-management support requires changes in the health system and by healthcare providers to help you and your family/whānau to take care of yourself and manage your long-term condition more successfully.

Why is self-management support important?

Increased self-management support improves:

  • adherence to medication and treatment regimes
  • decision-making
  • communication
  • coordination
  • satisfaction with the service the person is receiving
  • health outcomes
  • quality of life.

Self-management support reduces:

  • hospitalisations
  • health disparities.

Self-management education

undefinedTraditional patient education has been found relatively ineffective at changing behaviour. In contrast, self-management education is much more effective as it teaches individuals and their families/whanāu practical and generic skills that help them manage their health conditions.

Further, these skills tend to also improve their emotional, social and financial functioning, not only within their families but also their communities. Practically this results in improved health, wellbeing and ability to work as well as reduced family stress.

Self-management programmes

Stanford Model - Living a Healthier Life

This is a community-based programme generally held for 2.5 hours once a week for 6 weeks. The programme is used in over 22 countries around the world. There are a number of studies showing it is effective in helping people with a wide range of long-term conditions manage their health more effectively.

A number of organisations in New Zealand run self-management programmes based on this model, including Counties Manukau DHB and local primary health organisations such as ProCare Health, as well as Arthritis NZ (throughout the country).

Flinders Programme

This is a training programme and structured set of tools for healthcare providers to use when working one on one with clients and their families.

The tools facilitate assessment of a person's self-management capacity (what are the barriers and enablers) and what they see as their main problem or issue. The tools then help the healthcare provider and person together agree on the main issues, goals and interventions, resulting in an agreed care plan.

Again, this is an evidence-based approach that has proven very useful for working more collaboratively with clients and their families. For more information about the evidence-base and programme, visit the Flinders Program website.

Whānau Pakari - Taranaki’s intervention programme for children with weight issues

Whānau Pakari is a family-based healthy lifestyle programme that supports children and adolescents (aged 4-16) who are struggling with weight issues in the Taranaki region. It means healthy, self-assured whānau/families in every sense of the word.

The programme is run by a multidisciplinary team comprised of a HLC, paediatrician, dietitian, physical activity advisor and a psychologist. It offers a home-based medical assessment and weekly activity session in the same programme.

The programme has evolved to offer a suite of age-appropriate interventions and different levels of support, decided on through initial consultation with the whānau and their needs. For more information about the programme, visit the website.

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Background papers

What is self-management? A useful paper from the Flinders Human Behaviour and Health Research Unit (FHBHRU). It includes a discussion on the definition, a literature review covering information on self-management programmes, interventions, characteristics of effective programmes plus principles and concepts. 
Self-management: a background paper Dr Patrick Gowan, University of Victoria, Center on Aging, Canada, written for the New Perspectives: International Conference on Patient Self Management held in Canada, 2005.
Bycroft JJ, Tracey J. Self-management support: a win-win solution for the 21st century NZ Family Physician. 2006;44(3):243-248.

Learn more

For more information about self-management support, visit our dedicated Self-Management Support (SMS) Toolkit for healthcare providers. 

References

  1. Ritchie JE. From health education to education for health in Australia: a historical perspective Health Promotion International. 1991;6(2):157–163.
  2. Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial Med Care. 1999 Jan;37(1):5-14.
  3. Barlow J, Wright C, Sheasby J. Self-management approaches for people with chronic conditions: a review Patient Education and Counseling. 2002;48(2):177-87.
  4. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care 2002 Nov;288(19):2469-2475.
Credits: Health Navigator Editorial Team. Reviewed By: Dr Janine Bycroft, GP, Auckland Last reviewed: 15 Jan 2015