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Patient–provider perspectives on self‐management support and patient empowerment in chronic care: A mixed‐methods study in a rural sub‐Saharan setting.
- Source :
-
Journal of Advanced Nursing (John Wiley & Sons, Inc.) . Nov2019, Vol. 75 Issue 11, p2980-2994. 15p. 5 Charts, 1 Graph. - Publication Year :
- 2019
-
Abstract
- Aim: To explore how provision of self‐management support to chronically‐ill patients in resource‐limited settings contributes to patient empowerment in chronic care. Design: Concurrent descriptive mixed methods research. Methods: A survey of 140 patients with chronic conditions administered at four time‐points in 12 months. We conducted 14 interviews and four focus‐group discussions with patients (N = 31); 13 healthcare provider interviews; and observations of four patient‐support group meetings. Data were collected between April 2016 ‐ May 2017 in rural Malawi. Qualitative data were analysed using a thematic approach and descriptive statistical analysis performed on survey data. Results: Healthcare professionals facilitated patient empowerment through health education, although literacy levels and environmental factors affected self‐management guidance. Information exchanged during patient–provider interactions varied and discussions centred around medical aspects and health promoting behaviour. Less than 40% of survey patients prepared questions prior to clinic consultations. Health education was often unstructured and delegated to non‐physician providers, mostly untrained in chronic care. Patients accessed psychosocial support from volunteer‐led community home‐based care programmes. HIV support‐groups regularly interacted with peers and practical skills exchanged in a supportive environment, reinforcing patient's self‐mangement competence and proactiveness in health care. Conclusion: For optimal self‐management, reforms at inter‐personal and organizational level are needed including; mutual patient‐provider collaboration, diversifying access to self‐management support resources and restructuring patient support‐groups to cater to diverse chronic conditions. Impact: Our study provides insights and framing of self‐management support and empowerment for patients in long‐term care in sub‐Saharan Africa. Lessons drawn could feed into designing and delivering responsive chronic care interventions. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ATTITUDE (Psychology)
*CHRONIC diseases
*COHORT analysis
*FOCUS groups
*HEALTH
*HEALTH education
*HEALTH promotion
*HIV-positive persons
*INTERVIEWING
*RESEARCH methodology
*MEDICAL personnel
*PATIENT-professional relations
*SCIENTIFIC observation
*PATIENT education
*RESEARCH funding
*RURAL conditions
*SELF-efficacy
*SUPPORT groups
*SELF-management (Psychology)
*STATISTICS
*T-test (Statistics)
*INFORMATION resources
*QUALITATIVE research
*COMMUNITY support
*AFFINITY groups
*JUDGMENT sampling
*DATA analysis
*SOCIAL support
*COMMUNITY-based social services
*THEMATIC analysis
*DATA analysis software
*PATIENTS' attitudes
*DESCRIPTIVE statistics
*MANN Whitney U Test
Subjects
Details
- Language :
- English
- ISSN :
- 03092402
- Volume :
- 75
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Journal of Advanced Nursing (John Wiley & Sons, Inc.)
- Publication Type :
- Academic Journal
- Accession number :
- 139350089
- Full Text :
- https://doi.org/10.1111/jan.14116