Evolving 'self'-management: exploring the role of social network typologies on individual long-term condition management.

Rebecca L Morris,Caroline Sanders,Anne Kennedy

doi:10.1111/hex.12394

Rebecca L Morris, Caroline Sanders + Show 1 more

Open Access

https://doi.org/10.1111/hex.12394

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Abstract

BackgroundWhilst there has been a focus on the importance of social support for managing long‐term conditions, there has been little specific focus on the characteristics of social networks that shape self‐management. Policy emphasis is placed on individual responsibility for self‐care, and this influences commissioning of health‐care services. Assumptions are often made by policymakers about accessibility and preference for support and the influence of the social context on chronic illness management.ObjectiveTo examine the social networks of individuals with long‐term conditions and identify how the characteristics of their composition influences support needs.Design, setting and participantsThirty participants completed initial face‐to‐face in‐depth interviews, telephone follow‐ups and final face‐to‐face interviews in the north‐west of England. A longitudinal qualitative design was used to elicit the subtle changes in relationships over a year.FindingsThe findings suggest that the relationships which constitute a social network influence perceived support needs and attitudes to self‐management. The amalgamation of relationships was characterized into three network typologies (family focused, friend focused or health‐care professional focused) according to which types of relationships were dominant. In the absence of support, accounts highlighted a small number of substitutes who could provide support at times of critical need.DiscussionThis study challenges the notion of ‘self’‐management as an individual construct as many of the practices of illness management involved the support and/or negotiation of roles with others. By examining the nuances of relationships, this study has highlighted the tacit boundaries of practical and emotional support provision.

Highlights

Supporting self-management for individuals with long-term conditions has been a key aim of UK and global health policy
Whilst there has been a focus on the importance of social support for managing long-term conditions, there has been little specific focus on the characteristics of social networks that shape self-management
Assumptions are often made by policymakers about accessibility and preference for support and the influence of the social context on chronic illness management

Summary

Introduction

Supporting self-management for individuals with long-term conditions has been a key aim of UK and global health policy. Self-management is defined as the actions individuals take for themselves and their families to stay healthy and to care for minor, acute and long-term conditions.[1] The focus of formal self-care support has been on developing educational materials and improving communication between patients and clinicians.[2] Yet chronic disease self-management programmes have been identified as not prioritizing or tailoring goals that are of importance to patients.[3] Despite an espoused ethos of supporting a ‘social model’ of illness, in practice this is often lacking in self-management programmes.[4,5] Examining social networks for chronic illness management is one approach that may address this shortfall. Policy emphasis is placed on individual responsibility for self-care, and this influences commissioning of health-care services. Assumptions are often made by policymakers about accessibility and preference for support and the influence of the social context on chronic illness management

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