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

Abstract

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
Volume14
Issue number2
DOIs
Publication statusPublished - 1 Jun 2018

Cite this

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title = "Patients’ and healthcare professionals’ perceptions of self-management support interactions: Systematic review and qualitative synthesis",
abstract = "ObjectiveTo review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions.MethodsWe 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.ResultsThemes 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.DiscussionEncounters 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.",
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Patients’ and healthcare professionals’ perceptions of self-management support interactions : Systematic review and qualitative synthesis. / Franklin, Marika; Lewis, Sophie; Willis, Karen; Bourke-Taylor, Helen; Smith, Lorraine.

In: Chronic Illness, Vol. 14, No. 2, 01.06.2018, p. 79-103.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Willis, Karen

AU - Bourke-Taylor, Helen

AU - Smith, Lorraine

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N2 - ObjectiveTo review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions.MethodsWe 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.ResultsThemes 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.DiscussionEncounters 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.

AB - ObjectiveTo review studies examining the experience of self-management support in patient–provider interactions and the shaping of goals through interactions.MethodsWe 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.ResultsThemes 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.DiscussionEncounters 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.

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