Abstract
BackgroundThere currently exists a vast amount of literature concerning chronic illness self-management, however the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time.MethodTwenty-one individuals newly diagnosed with chronic illnesses (e.g., diabetes, rheumatism, ischemic heart disease, multiple sclerosis, chronic renal disease, inflammatory bowel disease) were repeatedly interviewed over two-and-a-half years. The interviews were conducted in Sweden from 2006 to 2008. A total of 81 narrative interviews were analyzed with an interpretive description approach.ResultsThe participants’ self-management behaviors could be described in four different developmental patterns: consistent, episodic, on demand, and transitional. The developmental patterns were related to specific self-management behaviors. Most participants took long-term medications in a consistent pattern, whereas exercise was often performed according to an episodic pattern. Participants managed health crises (e.g., angina, pain episodes) according to an on demand pattern and everyday changes due to illness (e.g., adaptation of work and household activities) according to a transitional pattern. All of the participants used more than one self-management pattern.ConclusionThe findings show that self-management does not develop as one uniform pattern. Instead different self-management behaviors are enacted in different patterns. Therefore, it is likely that self-management activities require support strategies tailored to each behavior’s developmental pattern.
Highlights
There currently exists a vast amount of literature concerning chronic illness self-management, the developmental patterns and sustainability of self-management over time remain largely unknown
When participants described how they managed to continue working with paid employment despite their condition, it was described as a transitional selfmanagement pattern; Participants changed their attitudes and approaches to work and learned to perform work-related tasks in new ways
All participants described using three or four different patterns depending on the type of self-management behavior
Summary
There currently exists a vast amount of literature concerning chronic illness self-management, the developmental patterns and sustainability of self-management over time remain largely unknown. This paper aims to describe the patterns by which different chronic illness self-management behaviors develop and are maintained over time. Individuals’ self-management is a crucial part of the care of people with chronic illness. All people are influenced – positively and negatively—by their social networks, health-care providers and society as a whole. Each of these can provide both resources for and barriers to self-management [3]. There currently exists a vast amount of research regarding self-management barriers and facilitators; the developmental patterns and sustainability of self-management over time remain largely unknown. The literature that describes self-management over time mostly consists of trials to improve individuals’ self-management or small qualitative studies that describe self-management development from predominately retrospective data
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