SELF-MANAGEMENT
SUPPORT
  • About Self-Management Support

Self-Management Support

Helping Patients To Self Manage
Supporting Patients to Take Control of Their Health
“Self-management support is a fundamental transformation of the patient-caregiver relationship into a collaborative partnership.”

Self-Management Support is More than Patient Education
Most individuals need help and encouragement to actively participate in their care and successfully perform a variety of tasks. Self-management support is defined as “the systematic provision of education and supportive interventions by health care staff to increase patients’ skills and confidence in managing their health problems, including regular assessment ofprogress and problems, goal setting, and problem-solving support.” Patients may interact with a nurse, social worker, or other professional rather than rely solely on a physician. The interaction may include coaching, with the goal of educating and empowering the patient and increasing self-efficacy for self-management behaviors.

Supporting Patients to Self Manage
Fundamental Shift in Relationship
Self-management support represents a fundamental shift in the patient-caregiver relationship. Rather than having health professions tell patients what to do to improve their health, the new model is designed to build a partnership between caregiver and patient, with a shared responsibility for making and carrying out health-related decisions. Caregivers provide patients expertise and tools; patients are responsible for their day-to-day health decisions.

Purpose of SM Support
The purpose of self-management support is to help patients become informed about their conditions and take an active role in treatment.

Two Interlocking Activities
Providing information about patients’ chronic conditions (helping patients to become informed).
Working in partnership with patients to make medical decisions, including taking medications recommended by clinicians, undergoing diagnostic or surgical procedures, and choosing health-behavior-related goals.

Traditional Interactions
Information and skills are taught based on the caregiver’s agenda;
There is an assumption that knowledge creates behavior change;
The goal is compliance with caregiver’s advice;

Collaborative Interactions
Information and skills are taught based on patient’s agenda;

Confidence in the ability to change (“self-efficacy”) together with knowledge, creates behavior change; The goal is increased confidence in the ability to change, rather than compliance with a caregiver’s advice;
Decisions are made as a patient-caregiver partnership.

Helping Patients Take Control
Self-management support involves both information giving and a collaborative partnership between caregiver and patient. Several strategies, techniques, and tools have been developed to assist patients within a collaborative model. The ‘5As’ model of behavior change (Glasgow et al.), provides a sequence of evidence-based clinician and office practice behaviors (Assess, Advise, Agree, Assist, Arrange) that can be applied in primary care settings to address a broad range of behaviors and health conditions.

Five A’s Defined
The ‘5As’ model of behavior change counseling is an evidence-based approach appropriate for abroad range of different behaviors and health conditions, and is feasible to apply in primary care. The 5As are as follows:

assessing patient level of behavior, beliefs and motivation;
advising the patient based upon personal health risks;
agreeing with the patient on a realistic set of goals;
assisting to anticipate barriers and develop a specific action plan; and
arranging follow-up support.

The support behaviors are centered around the patient and directed toward helping him or her to develop a personal action plan. The steps for the patient-caregiver collaboration are:

List specific goals in behavioral terms (what do you want to do, when, how much, and how often)
List barriers to carrying out goals and brainstorm strategies for addressing the barriers
Specify a follow-up plan (how well have you accomplished goal)
Share plan with healthcare team and personal support network.