Search

Objective To combine insights from service users with long-term conditions ( LTCs) to assist the development of a community referral intervention designed to promote engagement and improve access to health-relevant resources. Background Social deprivation and reduced access to resources have been causally linked with social isolation and the ability to manage LTCs. Participation in meaningful activity has been associated with positive health benefits, and strategies to promote access to community activities have shown some potential to improve outcomes for people with LTCs. This suggests the need to develop an engagement and referral intervention in partnership with service users and community groups as part of mainstream self-care support. Method A series of focus groups and interviews with members of community groups in Greater Manchester designed as an iterative and collaborative approach to elicit the role of personal and community networks that support long-term condition management ( LTCM) to develop a community referral tool. Results Participants reported a broad range of resources relevant to LTCM that often went beyond the usual concerns associated with self-care. This helped to inform a tool ( PLANS) to tailor access to types of community-based resources which can support LTCM. Conclusions Understanding the everyday challenges of living with a LTC highlighted the importance of connecting and engaging with localized support for people. In response to this, we developed an intervention ( PLANS) which tailors access to local resources based on personal preferences, needs and acceptability to encourage service users to engage with sustainable health choices. [ABSTRACT FROM AUTHOR]

The article focuses on the longitudinal qualitative study that investigates the influences self-management priorities for individuals with multiple long-term conditions. It mentions the effects of multiple conditions on many aspects of people's illness management. It also discusses the results of the study which finds the variable nature of multimorbidity experience and management for patients.

Background: An implementation gap exists between policy aspirations for provision and the delivery of self-management support in primary care. An evidence based training and support package using a whole systems approach implemented as part of a randomised controlled trial was delivered to general practice staff. The trial found no effect of the intervention on patient outcomes. This paper explores why self-management support failed to become part of normal practice. We focussed on implementation of tools which capture two key aspects of self-management support - education (guidebooks for patients) and forming collaborative partnerships (a shared decision-making tool). Objectives: To evaluate the implementation and embedding of self-management support in a United Kingdom primary care setting. Design: Qualitative semi-structured interviews with primary care professionals. Settings: 12 General Practices in the Northwest of England located within a deprived inner city area. Participants: Practices were approached 3-6 months after undergoing training in a selfmanagement support approach. A pragmatic sample of 37 members of staff - General Practitioners, nurses, and practice support staff from 12 practices agreed to take part. The analysis is based on interviews with 11 practice nurses and one assistant practitioner; all were female with between 2 and 21 years' experience of working in general practice. Methods: A qualitative design involving face-to-face, semi-structured interviews audio- recorded and transcribed. Normalisation Process Theory framework allowed a systematic evaluation of the factors influencing the work required to implement the tools. Findings: The guidebooks were embedded in daily practice but the shared decision- making tools were not. Guidebooks were considered to enhance patient-centredness and were minimally disruptive. Practice nurses were reluctant to engage with behaviour change discussions. Self-management support was not formulated as a practice priority and there was minimal support for this activity within the practice: it was not auditable; [ABSTRACT FROM AUTHOR]