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Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respe...

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Autores principales: Entwistle, Vikki A., Cribb, Alan, Owens, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816130/
https://www.ncbi.nlm.nih.gov/pubmed/27896539
http://dx.doi.org/10.1007/s10728-016-0335-1
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author Entwistle, Vikki A.
Cribb, Alan
Owens, John
author_facet Entwistle, Vikki A.
Cribb, Alan
Owens, John
author_sort Entwistle, Vikki A.
collection PubMed
description There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When (the promotion of) support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes (and then of failing to notice that as harmful); limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live (and die) well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people (both generally and more specifically) for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice.
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spelling pubmed-58161302018-02-27 Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well Entwistle, Vikki A. Cribb, Alan Owens, John Health Care Anal Original Article There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When (the promotion of) support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes (and then of failing to notice that as harmful); limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live (and die) well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people (both generally and more specifically) for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. Springer US 2016-11-28 2018 /pmc/articles/PMC5816130/ /pubmed/27896539 http://dx.doi.org/10.1007/s10728-016-0335-1 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Entwistle, Vikki A.
Cribb, Alan
Owens, John
Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title_full Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title_fullStr Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title_full_unstemmed Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title_short Why Health and Social Care Support for People with Long-Term Conditions Should be Oriented Towards Enabling Them to Live Well
title_sort why health and social care support for people with long-term conditions should be oriented towards enabling them to live well
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816130/
https://www.ncbi.nlm.nih.gov/pubmed/27896539
http://dx.doi.org/10.1007/s10728-016-0335-1
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