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Supporting Self-management

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Long term conditions and Self care / management

Around two million people, 40 per cent of the Scottish population, have at least one long term condition, and one in four adults over 16 report some form of long term illness, health problem or disability ( Scottish Government 2015).

Living with a long term condition involves three different kinds of tasks: care of the body and understanding and following complex medical regimes, adapting everyday activities and making changes to lifestyle, and dealing with the emotions arising from having the condition. (Source: Institute for Healthcare Improvement)

Self-management focuses on helping people help themselves to become active managers of their own health. It encourages people living with long term conditions to access information and to develop skills to manage their condition. This enables well informed decisions about their life and the realisation of their own personal goals.

There are a number of core elements to effectively support self-management including:

  1. Building supportive and collaborative relationships that help people to gain confidence and motivation to make changes to their lives.
  2. Developing partnerships to support care and shared decision making and working with others such as the voluntary sector.
  3. Adopting a risk enablement approaches in order to maximise a person's independence.
  4. Taking a strengths-based approach by valuing the whole person and capitalising on their talents, resources and connections, in other words their strengths and not their deficits.

What does this mean for the Effective Practitioner?

Effectively supporting self-management depends on practitioners taking a collaborative, person-centred approach that requires a cultural shift from the model of 'fixer' to 'enabler'. it is not 'doing to' but 'doing with' with the individual as the leading partner in managing their own life and condition(s).

The focus is on the person, their values, beliefs and experience and not on the condition. There should be a strong emphasis on health coaching. A person's willingness to engage in self-management can be affected by the quality of the relationship with the care provider therefore good communication skills are essential for effective and sustained self-management.

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  • Learning Activities

    Self-management can mean different things to different people, with a variety of techniques, tools and processes needed at the local level to support self management. In order to effectively support self management it can be useful to explore shared and individual views.

    • What are your beliefs and values in relation to self-management?
    • Discuss with a few colleagues what your shared beliefs and values in relation to self-management?
    • Consider whether a common vision could be developed for the team/service

    Record your learning in your professional portfolio.

    Related KSF core dimensions: personal and people development.

    There are many tools and techniques used for self-management including motivational interviewing, telephone coaching, goal setting and active group education. A face to face or telephone appointment with a practitioner or group is an opportunity for the person to discuss issues and receive support and information that enables them to manage their condition on a day to day basis.

    Identify someone who you feel could give you feedback on how your support patients/clients with long term conditions to self manage. Ask them to observe you during a discussion with a patient/client who has a long term condition and who agrees to be involved.

    • Ask your colleague to feedback on how you supported the person to self-manage.
    • Ask the patient/client about their experience during the discussion – did they get the support they expected or needed?
    • Were you able to provide them with the information they needed?
    • Were you able to jointly set goals with the person?
    • What might you do differently the next time you are meeting with a patient/client who has a long term condition to support them to self manage?

    Record your learning in your professional portfolio.

    Related KSF core dimensions: personal and people development, service improvement.

    Consider a person with a long term condition that you have worked with/cared for and who has been encouraged to self-manage?

    • Did you support the person to weigh up potential benefits and risks of choices and actions?
    • Did you support the individual to be optimistic about how they can manage their condition?
    • Discuss with colleagues and ask others how they might have supported them in enabling risk.
    • What might you do differently the next time risk is identified?

    Record your learning in your professional portfolio.

    Related KSF core dimensions: personal and people development, service improvement.

    Practitioners can increase support for people by signposting them to resources, networks and information.

    • Examine the people using your service and the types of conditions presented.
    • Select one condition.
    • Find out what resources, networks and information are available. Possible sources for this information might be (where applicable) your Managed Clinical Network leads, Long term Conditions co-ordinator, or look on the internet for local resources available.

    Think about the valuable contribution that the third sector can make.

    • What third sector organisations are in the local area and what do they have to offer?

    Record your learning in your professional portfolio.

    Related KSF core dimensions: service improvement and quality.

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Remember, recording your reflections is an important part of the learning process. Take time to structure your thoughts, feelings and any future actions on one the forms available in the Reflective Practice section. Click here to visit the page.

In your reflections you could also consider how your learning relates to the Facilitation of LearningLeadership and Evidence, Research and Development pillars of practice.

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