What is Self-Management?

November 17, 2011
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We need new models for health care because more people are living longer lives, which is good! ☺ But this means more people with long-term health problems requiring more of everything: medicines, hospital care and other support services. Which is bad ☹ And the cost of delivering high-quality care is spiraling out of control and it’s going to get a lot worse. We need new models for health care to ensure we avoid unsustainable levels of cost in the future and are still able to provide high quality care for all.

We need new models for health care because more people are living longer lives, which is good! ☺ But this means more people with long-term health problems requiring more of everything: medicines, hospital care and other support services. Which is bad ☹ And the cost of delivering high-quality care is spiraling out of control and it’s going to get a lot worse. We need new models for health care to ensure we avoid unsustainable levels of cost in the future and are still able to provide high quality care for all.

Some people find it hard to do the things that would help them stay well or get better, that’s why there’s a growing demand for services that provide new tools and techniques to help them – self-management services.

And the voices calling for self-management are mounting up. The King’s Fund says self-management services should be a high priority for commissioners of health care services. The government says “there should be no decision made about a patient’s care with the patient being involved”. The Health Foundation says that “proactively supporting self-management and focusing on behaviour change can have an impact”. They all agree that patient self-management is key to success but this potentially means changing people’s behavior.

But changing behavior is really hard – that’s why people need support. It’s hard to lose weight, start exercising or deal with the anger, fear and depression that many people have when they have a long-term health condition. They need lots of different stuff to help them.

The Health Foundation have done lots of evidence work on self-management and they think success is contingent on four key things happening:

1. Good information – information provision
2. Achieving self-confidence – self-efficacy.
3. Altering personal behavior – behavior change .
4. And the ability to go online or use medical devices and write things down –technical skills

But these elements on their own will not work. Self management services need to be mixed and matched according to the specific and personal needs of the patient to help them on the road to effective self-management. So for example, patients can be helped to set themselves goals that could lead to beneficial behaviour change – like feeling confident that they can achieve even something as simple as walking to the shops at least once or twice a week. But if it is not supported by good quality information then even the most well-intentioned patient may set themselves inappropriate or even harmful goals! At the same time, self-management services are not about people being pushed to do something. Self-management services are simply a mixture of tools and techniques and they’re all about providing people with a good range of service options that will help them. They are there to help large numbers of people to have their own light-bulb moment – that moment when they realise ‘I can do this!’, ‘I am confident and capable enough to manage my health needs!’.

And technology and the Internet can play an important role in helping people to reach that lightbulb moment and to then follow through with positive actions.
Above all, through improved information, communication and on-line tools, digital technologies can be a catalyst to better, warmer more equitable human relationships between patients and health care professionals.