Self-management support is defined as the education initiatives and support given by health care providers and staff to enable anyone with a long term condition to increase their skills and confidence in managing their health problems.
Support includes regular medical assessment of progress and problems, goal setting, and problem-solving approaches. Self-management support requires multilevel system changes to help individuals and their families to self care or manage more successfully.
Why is self-management important?
There is now good evidence that increased self-management support improves:
- adherence to medication and treatment regimes,
- satisfaction with the service they are receiving,
- health outcomes and quality of life;
- hospitalisations, and
- health disparities.
(K; Lorig, Sobel, Stewart, Brown, & et al, 1999) (Barlow, Wright, Sheasby, Turner, & Hainsworth, 2002) (M. Battersby, 2004) (Bodenheimer, 2003)
Traditional patient education has been found to be relatively ineffective at changing behaviour.(Ritchie, 1991) In contrast, self-management education is much more effective as it teaches individuals and their families practical and generic skills that help them manage their health conditions. Furthermore 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, ability to work and reduced family stress.
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 and 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 NZ run self management programmes based on this model including Counties Manukau DHB and local Primary Health Organisations, ProCare Health, Arthritis NZ (throughout the country).
This is a training programme and structured set of tools for health 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), what they see as their main problem or issue and then together to 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 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 multi-disciplinary 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 upon through initial consultation with the whānau and their needs. For more information about the programme, visit the website.
What is Self Management? – useful paper from the Flinders Human Behaviour and Health Research Unit (FHBHRU) which includes a discussion on the definition, literature review covers information on self management programmes, interventions, characteristics of effective programmes, plus principles and concepts (pdf, 207 KB,15 pages long including references)
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. NZFP August 2006. Vol 44, No.3. 243 – 248
More - An extensive list of references is available at Bibliography & References