Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis

Marika Franklin, Sophie Lewis, Karen Willis, Helen Bourke-Taylor, Lorraine Smith

Research output: Contribution to journalReview ArticleResearchpeer-review

61 Citations (Scopus)


Objective: To review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions. Methods: We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004–2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient–provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria. Results: Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients’ responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes ‘effective’ self-management. Discussion: Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.

Original languageEnglish
Pages (from-to)79-103
Number of pages25
JournalChronic Illness
Issue number2
Publication statusPublished - 1 Jun 2018


  • chronic conditions
  • chronic obstructive pulmonary disease
  • obesity
  • Patient–provider interactions
  • self-management support
  • type 2 diabetes mellitus

Cite this