Abstract
Self-management support forms a central aspect of chronic Illness management nationally and globally. Evidence for the success of self-management support has mainly focussed on individually-centred outcomes of behavioural change. While it is recognised that social network members play an important role there is currently a gap in knowledge regarding who provides what type of support and under what circumstances. This is relevant for understanding the division of labour and the meeting of needs for those living with a long-term condition. We therefore took a network approach to explore self-management support conceptualising it as types of illness ‘work’ undertaken within peoples’ social networks. 300 people from deprived areas and with chronic illnesses took part in a survey conducted in 2010 in the North West of England. A concentric circles diagram was used as a research tool with which participants identified 2,544 network members who contributed to illness management. The results provide an articulation of how social network members are substantially involved in illness management. Whilst partners and close family make the highest contributions there is evidence of inputs from a wide range of relationships. Network member characteristics (type of relationship, proximity, frequency of contact) impact on the amount of illness work undertaken in peoples’ networks. In networks with ‘no partner’ other people tend to contribute more in the way of illness related work than in networks with a partner. This indicates a degree of substitutability between differently constituted networks, and that the level and type of input by different members of a network might change according to circumstances. A network perspective offers an opportunity to redress the balance of an exclusively individual focus on self-management because it addresses the broader set of contributions and resources available to people in need of chronic illness management and support.
Highlights
As part of a ‘care transition’ self-management support policies for long-term conditions (LTCs) are designed to enhance peoples’ self-management capacities and reduce the fiscal burden on health care systems [1,2]
In policy terms [3] the work related to chronic illness has been divided across three levels: case management is for patients with multiple complex conditions, involving intensive proactive professionally delivered care to avoid complications and admissions; disease management is for patients at some risk who are managed through guideline-based programmes in primary care; and self-care support refers to the longer term and more mundane work for those considered at ‘low risk’ (70–80% of those with LTCs)
Who are the Social Network Members Contributing to Chronic Illness Work?: Relationship Types, Proximity and Gender The 300 participants included in the study identified a total of
Summary
As part of a ‘care transition’ self-management support policies for long-term conditions (LTCs) are designed to enhance peoples’ self-management capacities and reduce the fiscal burden on health care systems [1,2]. This has necessitated the reconfiguration of organisational interfaces, introduction of new technologies, and reconsideration of the work that stems from chronic illness. We look to the development of an approach capable of in-depth exploration of the nature and capacity of support provided by others [10,11]
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