Self-management in chronic illness: concept and dimensional analysis

Abstract

udlis ka (2011) Journal of Nursing and Healthcare of Chronic Illness3, 130–139Self-management in chronic illness: concept and dimensional analysis Aim. To define self-management in chronic illness and explore the concept. Background. Successful management of chronic illness requires an integrated approach with active involvement of the patient, family and healthcare professional. The term self-management is used extensively within the literature as a method to improve chronic illness outcomes and is recognised as an essential component in the treatment of persons with chronic illness, yet the concept of self-management varies greatly depending on context and perspective. As patient involvement is the essence of self-management, the concept of self-management is in need of further exploration. Methods. Dimensional analysis provides the optimal approach to analysing the concept of self-management in chronic illness as it seeks to offer an understanding of the concept through its social construction and examines differences across perspectives and contexts. Conclusions. Antecedents, dimensions and consequences of self-management were identified and a definition and model of self-management was constructed. The salient dimension of adherence to a plan represents the dominance of the healthcare professional’s perspective in the literature. Further research exploring self-management from the patient’s perspective and encompassing all the aspects of the self-management model is necessary to accurately evaluate the consequences of improved quality of life, improved clinical outcomes and reduced healthcare expenditures. Relevance to clinical practice. Antecedents and dimensions of self-management derived from the chronic illness literature can be used to formulate tailored plans aimed at fostering successful self-management in patients as well as to guide interventions to improve self-management and patient outcomes.