Chronic Disease Self-Management

Abstract

The prevalence of chronic disease continues to increase as our population ages. Today, many older people have more than one chronic condition. Thus comorbidity is a problem for both the individual and for our health care system. This article discusses the rationale and definition for a self-management model. In addition, it gives examples from both medical care and health education of how this model has been applied. Finally, it defines the key components for patient education programs built on this model. These include (a) content presentation focused on patients' perceived needs, (b) practice and feedback in new skills, including decision making and problem solving, (c) attention to emotional and role management in addition to medical management, (d) use of techniques to increase patients' confidence in their ability to manage their conditions, and (e) emphasis on the patients' active role in the physician/patient relationship.

Get full access to this article

View all access options for this article.

References

Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.

Cambell, B. F. , Sengupta, S. , Santos, C. , & Lorig, K. (1995). Balanced incomplete block design: Description, case study, and implications for practice. Health Education Quarterly, 22, 201-210.

Clark, N. , Becker, M. , Janz, N. , Lorig, K. , Rakowski, W. , & Anderson, L. (1991). Self-management of chronic disease by older adults: A review and questions for research. Journal of Aging and Health, 3, 3-27.

Corbin, J. , & Strauss, A. (1988). Understanding work and care: Managing chronic illness at home. San Francisco, CA: Jossey-Bass.

DeBusk, R. F. , Miller, N. H. , Superko, H. R. , Dennis, C. A. , Thomas, R. J. , Lew, H. T. , Berger, W. E. 3rd , Heller, R. S. , Rompf, J. , Gee, D. , et al. (1994). A case-management system for coronary risk factor modification after acute myocardial infarction. Annals of Internal Medicine, 120, 721-729.

Holman, H. R. , & Lorig, K. (1992). Perceived self-efficacy in self-management of chronic disease. In R. Schwarzer (Ed.), Self-efficacy: Thought control of action. Bristol, PA: Hemisphere.

Lorig, K. , & González, V. (1992). The integration of theory with practice: A twelve-year case study. Health Education Quarterly, 19(3), 355-368.

Lorig, K. , & Holman, H. (1993). Arthritis self-management studies: A twelve-year review. Health Education Quarterly, 20(1), 17-28.

Lorig, K. , Mazonson, P. , & Holman, H. (1993). Evidence suggesting that health education for self-management in chronic arthritis has sustained health benefits while reducing health care costs. Arthritis and Rheumatism, 36(4), 439-446.

10.

Lubeck, D. P. , Brown, B. W. , & Holman, H. R. (1985). Chronic disease and health system performance: Care of osteoarthritis across three health services. Medical Care, 23(3), 266-277.

11.

Rothenberg, R. B. , & Koplan, J. P. (1990). Chronic disease in the 1990's. Annual Review of Public Health, 2, 267-296.

12.

Verbrugge, L. M. (1984). Longer life but worsening health? Trends in health and mortality of middle-aged and older persons. Milbank Memorial Fund Quarterly, 62, 475-519.

13.

Vickery, D. M. , & Fries, J. F. (1994). Take care of yourself: A consumer's guide to medical care (5th ed.). Reading, MA: Addison-Wesley.

14.

Wasson, J. , Gaudette C. , Whaley, F. , Sauvigne, A. , Baribeau, P. , Welch, H. G. (1992). Telephone care as a substitute for routine clinic follow-up. Journal of the American Medical Association, 267(13), 1788-1793.