Self management is generally defined as the day to day activities that an individual carries out to manage their long term health condition. Self management recognises that the individual’s own behaviors, beliefs and emotional state can significantly affect their health outcomes and quality of life, and that the individual is responsible for making changes to these behaviors with the support of the health care professionals.
These activities may include:
- Changing diet and levels of exercise
- Learning to deal with anxiety and depression
- Making changes to employment
- Actively monitoring their symptoms and reporting unusual changes to their health care team
On another level, self management may be seen as the transformation of the doctor /patient relationship away from a traditional paternalistic arrangement to one of partnership, where the patients experience and expertise is fully utilised.
Self management support refers to the services put in place to support the person to make positive changes to their lives and to maintain those changes. This may include courses for people when newly diagnosed e.g. diabetes, angina, or generic courses that provide support for the management of common symptoms and behaviours such as pain, fatigue, stress and diet. Individual coaching, telephone support and online programmes are also commonly used.
Skills for health care professionals
To ensure that self management and self management support is effective, then it is essential that both people with long term health conditions and their care teams are supported in developing the core skills that enable changes in health behaviors and beliefs.
The skills for health care professionals have been identified as (but not limited to) (Wagner et al. 2001):
- Establishing an empathic clinician-patient relationship
- Joint agenda setting for each consultation
- Collaborative goal setting
- Exploring ambivalence about change
- Using problem-solving skills
- Using systematic tools to support goals’ follow up
With thanks to ENOPE (Patient Empowerment. Living with Chronic Disease)
“Part of a series of short discussion topics on different aspects of self-management and patient empowerment written by ENOPE members for the 1st European conference on patient empowerment (ENOPE)”