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Sadler E, Wolfe CD, McKevitt C. Lay and health care professional understandings of self-management: A systematic review and narrative synthesis. SAGE Open Med. 2014;2:2050312114544493doi: 10.1177/2050312114544493.
Sadler, E., Wolfe, C. D., & McKevitt, C. (2014). Lay and health care professional understandings of self-management: A systematic review and narrative synthesis. SAGE open medicine, 22050312114544493. https://doi.org/10.1177/2050312114544493
Sadler, Euan, et al. "Lay and health care professional understandings of self-management: A systematic review and narrative synthesis." SAGE open medicine vol. 2 (2014): 2050312114544493. doi: https://doi.org/10.1177/2050312114544493
Sadler E, Wolfe CD, McKevitt C. Lay and health care professional understandings of self-management: A systematic review and narrative synthesis. SAGE Open Med. 2014 Aug 28;2:2050312114544493. doi: 10.1177/2050312114544493. eCollection 2014. PMID: 26770733; PMCID: PMC4607208.
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SAGE Open Med. 2014 Aug 28;2:2050312114544493. doi: 10.1177/2050312114544493. eCollection 2014.

Lay and health care professional understandings of self-management: A systematic review and narrative synthesis.

SAGE open medicine

Euan Sadler, Charles D A Wolfe, Christopher McKevitt

Affiliations

  1. Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, King's College London, London, UK.
  2. Department of Primary Care and Public Health Sciences, Division of Health and Social Care Research, King's College London, London, UK; National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.

PMID: 26770733 PMCID: PMC4607208 DOI: 10.1177/2050312114544493

Abstract

OBJECTIVES: Self-management is widely promoted but evidence of effectiveness is limited. Policy encourages health care professionals to support people with long-term conditions to learn self-management skills, yet little is known about the extent to which both parties share a common understanding of self-management. Thus, we compared health care professional and lay understandings of self-management of long-term conditions.

METHODS: Systematic review and narrative synthesis of qualitative studies identified from relevant electronic databases, hand-searching of references lists, citation tracking and recommendations by experts.

RESULTS: In total, 55 studies were included and quality was assessed using a brief quality assessment tool. Three conceptual themes, each with two subthemes were generated: traditional and shifting models of the professional-patient relationship (self-management as a tool to promote compliance; different expectations of responsibility); quality of relationship between health care professional and lay person (self-management as a collaborative partnership; self-management as tailored support) and putting self-management into everyday practice (the lived experience of self-management; self-management as a social practice).

CONCLUSION: Self-management was conceptualised by health care professionals as incorporating both a biomedical model of compliance and individual responsibility. Lay people understood self-management in wider terms, reflecting biomedical, psychological and social domains and different expectations of responsibility. In different ways, both deviated from the dominant model of self-management underpinned by the concept of self-efficacy. Different understandings help to explain how self-management is practised and may help to account for limited evidence of effectiveness of self-management interventions.

Keywords: Self-management; health care professionals; lay people; long-term conditions; narrative synthesis

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