Supporting chronic disease self-management: translating policies and principles into clinical practiceRosemary Higgins A D , Barbara Murphy A B , Marian Worcester A B and Angela Daffey C
A Heart Research Centre, Box 2137, Royal Melbourne Hospital, Melbourne, Vic. 3050, Australia.
B Department of Psychiatry, The University of Melbourne, Level 1, North Main Block, Royal Melbourne Hospital, Melbourne, Vic. 3050, Australia.
C Department of Psychology and Psychiatry, Building 17, Clayton Campus, Monash University, Wellington Road, Vic. 3800, Australia.
D Corresponding author. Email: email@example.com
Australian Journal of Primary Health 18(1) 80-87 http://dx.doi.org/10.1071/PY11006
Submitted: 24 January 2011 Accepted: 26 May 2011 Published: 21 October 2011
To support self-management, health professionals need to adopt a client-centred approach and learn to deliver evidence-based behaviour change interventions. This paper reports on the evaluation of 1- and 2-day training programs developed to improve health professionals’ capacity to support chronic disease self-management (CDSM). The 321 participants attended one of eighteen supporting CDSM courses held in urban and rural settings. Participants included nurses, allied health professionals, Aboriginal health workers and general practitioners. Data were collected at three time points: before participation; immediately after the training; and, for a sub-sample of 37 participants, 2 months after the training. Results revealed a significant and sustained increase in CDSM self-efficacy following training regardless of participants’ gender, age or qualifications. A thematic analysis of the responses concerning intended practice revealed four main areas of intended practice change, namely: use behavioural strategies; improve communication with clients; adopt a client-centred approach; and improve goal setting. The number of practice changes at 2 months reported by a sub-sample of participants ranged from 1 to 20 with a mean of 14 (s.d. = 4). The three most common areas of practice change point to the adoption by health professionals of a collaborative approach with chronic disease patients. Lack of staff trained in CDSM was seen as a major barrier to practice change, with lack of support and finance also named as barriers to practice change. Participants identified that increased training, support and awareness of the principles of supporting CDSM would help to overcome barriers to practice change. These results indicate a readiness among health professionals to adopt a more collaborative approach given the skills and the tools to put this approach into practice.
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