We need to talk about purpose: a critical interpretive synthesis of health and social care professionals’ approaches to self-management support for people with long-term conditions

Heather May Morgan, Vikki A. Entwistle, Alan Cribb, Simon Christmas, John Owens, Zoe C. Skea, Ian S. Watt

Research output: Contribution to journalArticle

38 Citations (Scopus)
9 Downloads (Pure)

Abstract

Background
Health policies internationally advocate ‘support for self-management’, but it is not clear how the promise of the concept can be fulfilled.

Objective
To synthesize research into professional practitioners’perspectives, practices and experiences to help inform a reconceptualization of support for self-management.

Design
Critical interpretive synthesis using systematic searches of literature published 2000–2014.

Findings
We summarized key insights from 164 relevant papers in an annotated bibliography. The literature illustrates striking variations in approaches to support for self-management and interpretations of associated concepts. We focused particularly on the somewhat neglected question of the purpose of support. We suggest that this can illuminate and explain important differences between narrower and broader approaches. Narrower approaches support people to manage their condition(s) well in terms of disease control. This purpose can underpin more hierarchical practitioner–patient communication and more limited views of patient empowerment. It is often associated with experiences of failure and frustration. Broader approaches support people to manage well with their condition(s). They can keep work on disease control in perspective as attention focuses on what matters to people and how they can be supported to shape their own lives. Broader approaches are currently less evident in practice.

Discussion and conclusion
Broader approaches seem necessary to fulfil the promise of support for self-management, especially for patient empowerment. A commitment to enable people to live well with long-term conditions could provide a coherent basis for the forms and outcomes of support that policies aspire to. The implications of such a commitment need further attention.
Original languageEnglish
Pages (from-to)243-259
Number of pages17
JournalHealth Expectations
Volume20
Issue number2
Early online date14 Apr 2016
DOIs
Publication statusPublished - Apr 2017

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Self Care
Delivery of Health Care
Patient Participation
Frustration
Professional Practice
Bibliography
Health Policy
Communication
Research

Keywords

  • Support for self-management
  • professional-patient relations
  • patient participation
  • patient empowerment
  • chronic conditions
  • long-term conditions
  • diabetes

Cite this

We need to talk about purpose : a critical interpretive synthesis of health and social care professionals’ approaches to self-management support for people with long-term conditions. / Morgan, Heather May; Entwistle, Vikki A.; Cribb, Alan; Christmas, Simon; Owens, John ; Skea, Zoe C.; Watt, Ian S.

In: Health Expectations, Vol. 20, No. 2, 04.2017, p. 243-259.

Research output: Contribution to journalArticle

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