Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

What skills do primary health care professionals need to provide effective self-management support?
Seeking consumer perspectives

Sharon Lawn A E , Malcolm Battersby A , Helen Lindner B , Rebecca Mathews B , Steve Morris C , Leanne Wells C , John Litt D and Richard Reed D
+ Author Affiliations
- Author Affiliations

A Flinders Human Behaviour and Health Research Unit, Flinders University, Adelaide, SA 5001, Australia.

B Australian Psychological Society, PO Box 38, Flinders Lane, Melbourne, Vic. 8009, Australia.

C Australian General Practice Network, PO Box 4308, Manuka, ACT 2603, Australia.

D Department of General Practice, Flinders University, Adelaide, SA 5001, Australia.

E Corresponding author. Email: sharon.lawn@health.sa.gov.au

Australian Journal of Primary Health 15(1) 37-44 https://doi.org/10.1071/PY08053
Published: 19 March 2009

Abstract

This research aimed to identify the skills required by primary health care (PHC) professionals to provide effective chronic condition prevention and self-management support, according to the perceptions of a sample of Australian consumers and carers. Qualitative data were collected and integrated from a focus group, key informant interviews and National Stakeholder meetings and a National Workshop, supported by an extensive literature review. With the exception of health professionals specifically trained or currently working in this area, consumers and carers perceive there is a lack of understanding, competence and practice of chronic condition prevention and self-management support among PHC professionals. The PHC workforce appears not to have the full set of skills needed to meet the growing burden of chronic conditions on the health system. Recommendations include education and training that focuses on improved communication skills, knowledge of community support resources, identification of consumers’ strengths and current capacities, collaborative care with other health professionals, consumers and carers and psychosocial skills to understand the impact of chronic conditions from the person’s perspective.

Additional keywords: chronic condition self management, patient-centred care.


Acknowledgements

This project was funded by the Australian Government Department of Health and Ageing through the Australian Better Health Initiative. The information and opinions contained in this article do not necessarily reflect the views or policies of the Australian Government Department of Health and Ageing.


References


Australian Institute of Health and Welfare (2004) ‘Australia’s health, 2004 .’ (AIHW: Canberra)

Barlow JH, Turner AP, Wright CC (2000) A randomized controlled study of the arthritis self-management programme in UK. Health Education Research 15, 665–680.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed | [Verified 4 March 2009]

Chodosh J, Morton SC, Mojica W, Maglione MM, Suttorp MJ , et al. (2005) Meta-analysis: chronic disease self-management programs for older adults. Annals of Internal Medicine 143, 427–438.
PubMed | [Verified 4 March 2009]

Coulter A , Ellins J (2006) ‘Patient-focused interventions: a review of the evidence.’ (The Health Foundation: London) Available at http://www.health.org.uk/publications/research_reports/patientfocused.html [Verified 10 October 2007]

Dysvik E, Natvig GK, Eikeland O, Brattberg G (2005) Results of a multidisciplinary pain management program: a 6- and 12-month follow-up study. Rehabilitation Nursing 30(5), 198–205.
PubMed | open url image1

Evans WG, Tulsky JA, Back AL, Arnold RM (2006) Communication at times of transition: how to help patients cope with lost and redefine hope. Cancer Journal 12, 417–424.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Glasgow R, Orleans TC, Wagner EH, Curry S, Solberg L (2001) Does the chronic care model serve also as a template for improving prevention? Milbank Quarterly 79, 579–612.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Infante FA, Proudfoot JG, Davies G, Bubner TK, Holton CH, Beilby JJ, Harris MF (2004) How people with chronic illnesses view their care in general practice: a qualitative study. The Medical Journal of Australia 181, 70–73.
PubMed | open url image1

Jenkinson C, Coulter A, Bruster S, Richards N, Chandola T (2002) Patients’ experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care. Quality and Safety in Healthcare 11, 335–339.
PubMed |  CAS | Crossref | open url image1

Joffe S., Manocchia M., Weeks J.C., Clearly P.D. (2003) What do patients value in their hospital care? An empirical perspective on autonomy centred bioethics. Journal of Medical Ethic 29, 103–108.
Crossref | GoogleScholarGoogle Scholar | CAS | open url image1

Little P, Everett H, Williamson I, Warner G, Moore M, Gould C, Ferrier K, Payne S (2001) Preferences of patients of patient centred approach to consultation in primary care: observational study. British Medical Journal 322, 468–472.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Lorig K, Ritter P, Stewart A, Sobel DS, Brown BW , et al. (2001) Chronic disease self-management program: 2 year health status and health care utilization outcomes. Medical Care 39, 1217–1223.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Lorig K , Holman H , Sobel D , Laurent D , González V , Minor M (2006) ‘Living a healthy life with chronic conditions.’ 3rd edn . (Bull Publishing Company: Boulder, CO)

Mann D, Gaylord S, Norton S (2004) Moving toward integrative care: rationales, models, and steps for conventional-care providers. Complementary Health Practice Review 9, 155–172.
Crossref | GoogleScholarGoogle Scholar | open url image1

McCaffery KJ, Shepher HL, Trevena L, Juraskova I, Barratt A , et al. (2007) Shared decision-making in Australia. Zeitschrift fur Arztliche Fortbildung und Qualitatssicherung 101, 205–211.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

McWilliam CL, Coleman S, Melito C, Sweetland D, Saidak J , et al. (2003) Building empowering partnerships for inter-professional care. Journal of Interprofessional Care 17(4), 363–376.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Michie S, Miles J, Weinman J (2003) Patient-centredness in chronic illness: what is it and does it matter? Patient Education and Counseling 51(3), 197–206.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Miles MB , Huberman AM (1994) ‘Qualitative data analysis: an expanded sourcebook.’ 2nd edn. (Sage Publications: Thousand Oaks, CA)

National Health Priority Action Council (2006) ‘National chronic disease strategy.’ (Australian Government Department of Health and Ageing: Canberra)

Neuman WL (2006) ‘Social research methods: qualitative and quantitative approaches.’ (Pearson/Allyn & Bacon: Boston)

Pruitt SD, Epping-Jordan JA (2005) Preparing the 21st century global healthcare workforce. British Medical Journal 330, 637–639.
Crossref | PubMed |
open url image1

RACGP (2006) ‘Putting prevention into practice: guidelines for the implementation of prevention in the general practice setting.’ 2nd edn. (RACGP: Melbourne)

Schoen C, Osborn R, Huynh PT, Doty MM, Peugh J, Zapert K (2006) On the front lines of care: Primary care doctors’ office systems, experiences, and views in seven countries. Health Affairs 25, w555–w571.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Symonds D, Parker R (2007) The Top End Mental Health Services General Practice Clinic: an initiative for patients with serious mental illness. Australasian Psychiatry 15(1), 58–61.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

Wagner E, Austin B, Von Korff M (1996a) Improving outcomes in chronic illness. Managed Care Quarterly 4, 12–25.
CAS | PubMed |
open url image1

Wagner E, Austin B, Von Korff M (1996b) Organizing care for patients with chronic illness. The Milbank Quarterly 74, 511–542.
Crossref | GoogleScholarGoogle Scholar | PubMed | CAS | open url image1

Ware NC, Tugenberg T, Dickey D (2004) Practitioner relationships and quality of care for low-income persons with serious mental illness. Psychiatric Services 55, 555–559.
Crossref | PubMed |
open url image1

Warsi A, Wang PS, LaValley MP, Avorn J, Solomon DH (2004) Self-management education programs in chronic disease. Archives of Internal Medicine 164, 1641–1649.
Crossref | GoogleScholarGoogle Scholar | PubMed | open url image1

World Health Organization (2002) ‘Innovative care for chronic conditions: building blocks for action: global report .’ (World Health Organization: Geneva)

World Health Organization (2005) ‘Preparing a health care workforce for the 21st century. The challenge of chronic conditions.’ (World Health Organization: France)