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Published in: BMC Primary Care 1/2011

Open Access 01-12-2011 | Research article

Self-care in people with long term health problems: a community based survey

Authors: Fiona MacKichan, Charlotte Paterson, William E Henley, Nicky Britten

Published in: BMC Primary Care | Issue 1/2011

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Abstract

Background

Self-care is a key component of current policies to manage long term conditions. Although most people with long-term health problems care for themselves within lay networks, consultation rates for long-term undifferentiated illness remain high. Promotion of self-care in these individuals requires an understanding of their own self-care practices and needs to be understood in the context of health care pluralism. The aim was to investigate the extent and nature of self-care practices in patients experiencing long term health problems, sources of information used for self-care, and use of other forms of health care (conventional health care and complementary and alternative medicine).

Methods

The study involved a cross-sectional community-based survey set in three general practices in South West England: two in urban areas, one in a rural area. Data were collected using a postal questionnaire sent to a random sample of 3,060 registered adult patients. Respondents were asked to indicate which of six long term health problems they were experiencing, and to complete the questionnaire in reference to a single (most bothersome) problem only.

Results

Of the 1,347 (45% unadjusted response rate) who responded, 583 reported having one or more of the six long term health problems and 572 completed the survey questionnaire. Use of self-care was notably more prevalent than other forms of health care. Nearly all respondents reported using self-care (mean of four self-care practices each). Predictors of high self-care reported in regression analysis included the reported number of health problems, bothersomeness of the health problem and having received a diagnosis. Although GPs were the most frequently used and trusted source of information, their advice was not associated with greater use of self-care.

Conclusions

This study reveals both the high level and wide range of self-care practices undertaken by this population. It also highlights the importance of GPs as a source of trusted information and advice. Our findings suggest that in order to increase self-care without increasing consultation rates, GPs and other health care providers may need more resources to help them to endorse appropriate self-care practices and signpost patients to trusted sources of self-care support.
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Literature
1.
go back to reference Kleinman A: Patients and Healers in the Context of Culture. 1980, Berkeley: University of California Press Kleinman A: Patients and Healers in the Context of Culture. 1980, Berkeley: University of California Press
2.
go back to reference Barofsky I: Compliance, adherence and therapeutic alliance: Steps in the development of self care. Soc Sci Med. 1978, 12: 369-76.PubMed Barofsky I: Compliance, adherence and therapeutic alliance: Steps in the development of self care. Soc Sci Med. 1978, 12: 369-76.PubMed
3.
go back to reference Rogers AH, S : Self-Care and Access to Health Care. Opportunities for Improving Access to Care. NHSE Anglia and Oxford Region. 1998, Milton Keynes Rogers AH, S : Self-Care and Access to Health Care. Opportunities for Improving Access to Care. NHSE Anglia and Oxford Region. 1998, Milton Keynes
4.
go back to reference Safford MM, Russell L, Suh DC, Roman S, Pogach L: How much time do patients with diabetes spend on self-care?. J Am Board Fam Pract. 2005, 18 (4): 262-70. 10.3122/jabfm.18.4.262.CrossRefPubMed Safford MM, Russell L, Suh DC, Roman S, Pogach L: How much time do patients with diabetes spend on self-care?. J Am Board Fam Pract. 2005, 18 (4): 262-70. 10.3122/jabfm.18.4.262.CrossRefPubMed
5.
go back to reference Department of Health: Self Care: A National View in 2007 Compared to 2004-05. 2008, London: Crown Copyright Department of Health: Self Care: A National View in 2007 Compared to 2004-05. 2008, London: Crown Copyright
7.
8.
go back to reference Chapple A, Rogers A: 'Self-care' and its relevance to developing demand management strategies: a review of qualitative research. Health & Social Care in the Community. 1999, 7 (6): 445-54. 10.1046/j.1365-2524.1999.00212.x.CrossRef Chapple A, Rogers A: 'Self-care' and its relevance to developing demand management strategies: a review of qualitative research. Health & Social Care in the Community. 1999, 7 (6): 445-54. 10.1046/j.1365-2524.1999.00212.x.CrossRef
9.
go back to reference Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J: Self-management approaches for people with chronic conditions: a review. Patient Education & Counseling. 2002, 48 (2): 177-87. 10.1016/S0738-3991(02)00032-0.CrossRef Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J: Self-management approaches for people with chronic conditions: a review. Patient Education & Counseling. 2002, 48 (2): 177-87. 10.1016/S0738-3991(02)00032-0.CrossRef
10.
go back to reference Newman S, Steed L, Mulligan K: Self-management interventions for chronic illness. Lancet. 2004, 364 (9444): 1523-37. 10.1016/S0140-6736(04)17277-2.CrossRefPubMed Newman S, Steed L, Mulligan K: Self-management interventions for chronic illness. Lancet. 2004, 364 (9444): 1523-37. 10.1016/S0140-6736(04)17277-2.CrossRefPubMed
11.
go back to reference Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ: The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?. Int J Epidemiol. 2006, 35 (2): 468-76.CrossRefPubMed Aggarwal VR, McBeth J, Zakrzewska JM, Lunt M, Macfarlane GJ: The epidemiology of chronic syndromes that are frequently unexplained: do they have common associated factors?. Int J Epidemiol. 2006, 35 (2): 468-76.CrossRefPubMed
12.
go back to reference Schon DS: The reflective practitioner. How professional think in action. 1995, Aldershot: Arena Schon DS: The reflective practitioner. How professional think in action. 1995, Aldershot: Arena
13.
go back to reference Peveler R, Kilkenny L, Kinmonth AL: Medically unexplained physical symptoms in primary care: A comparison of self report screening questionnaires and clinical opinion. J Psychosom Res. 1997, 42: 245-52. 10.1016/S0022-3999(96)00292-9.CrossRefPubMed Peveler R, Kilkenny L, Kinmonth AL: Medically unexplained physical symptoms in primary care: A comparison of self report screening questionnaires and clinical opinion. J Psychosom Res. 1997, 42: 245-52. 10.1016/S0022-3999(96)00292-9.CrossRefPubMed
14.
go back to reference Carson AJ, Best S, Postma K, Stone J, Warlow C, Sharpe M: The outcome of neurology outpatients with medically unexplained symptoms: a prospective cohort study. J Neurol. 2003, 74: 897-900. Carson AJ, Best S, Postma K, Stone J, Warlow C, Sharpe M: The outcome of neurology outpatients with medically unexplained symptoms: a prospective cohort study. J Neurol. 2003, 74: 897-900.
15.
go back to reference Helman CG: Disease versus illness in general practice. Journal of the Royal College of General Practice. 1981, 31: 548-52. Helman CG: Disease versus illness in general practice. Journal of the Royal College of General Practice. 1981, 31: 548-52.
16.
go back to reference Balint M: The Doctor, the Patient and His Illness. 1957, London: Tavistock Balint M: The Doctor, the Patient and His Illness. 1957, London: Tavistock
18.
go back to reference Rogers A, Entwistle V, Pencheon D: Managing demand - A patient led NHS: Managing demand at the interface between lay and primary care. BMJ. 1998, 316 (7147): 1816-1819.CrossRefPubMedPubMedCentral Rogers A, Entwistle V, Pencheon D: Managing demand - A patient led NHS: Managing demand at the interface between lay and primary care. BMJ. 1998, 316 (7147): 1816-1819.CrossRefPubMedPubMedCentral
19.
go back to reference Stevenson FA, Britten N, Barry CA, Bradley CP, Barber N: Self-treatment and its discussion in medical consultations: how is medical pluralism managed in practice?. Soc Sci Med. 2003, 57 (3): 513-27. 10.1016/S0277-9536(02)00377-5.CrossRefPubMed Stevenson FA, Britten N, Barry CA, Bradley CP, Barber N: Self-treatment and its discussion in medical consultations: how is medical pluralism managed in practice?. Soc Sci Med. 2003, 57 (3): 513-27. 10.1016/S0277-9536(02)00377-5.CrossRefPubMed
20.
go back to reference Segall A, Goldstein J: Exploring the Correlates of Self-Provided Health-Care Behavior. Soc Sci Med. 1989, 29 (2): 153-61. 10.1016/0277-9536(89)90163-9.CrossRefPubMed Segall A, Goldstein J: Exploring the Correlates of Self-Provided Health-Care Behavior. Soc Sci Med. 1989, 29 (2): 153-61. 10.1016/0277-9536(89)90163-9.CrossRefPubMed
21.
go back to reference Verbrugge LM, Ascione FJ: Exploring the Iceberg - Common Symptoms and How People Care for Them. Med Care. 1987, 25 (6): 539-69. 10.1097/00005650-198706000-00008.CrossRefPubMed Verbrugge LM, Ascione FJ: Exploring the Iceberg - Common Symptoms and How People Care for Them. Med Care. 1987, 25 (6): 539-69. 10.1097/00005650-198706000-00008.CrossRefPubMed
22.
go back to reference Kroenke K, Price RK: Symptoms in the Community - Prevalence, Classification, and Psychiatric Comorbidity. Arch Intern Med. 1993, 153 (21): 2474-80. 10.1001/archinte.153.21.2474.CrossRefPubMed Kroenke K, Price RK: Symptoms in the Community - Prevalence, Classification, and Psychiatric Comorbidity. Arch Intern Med. 1993, 153 (21): 2474-80. 10.1001/archinte.153.21.2474.CrossRefPubMed
23.
24.
go back to reference Henningsen P, Zipfel S, Herzog W: Management of functional somatic syndromes. Lancet. 2007, 369 (9565): 946-55. 10.1016/S0140-6736(07)60159-7.CrossRefPubMed Henningsen P, Zipfel S, Herzog W: Management of functional somatic syndromes. Lancet. 2007, 369 (9565): 946-55. 10.1016/S0140-6736(07)60159-7.CrossRefPubMed
25.
go back to reference Burton C: Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS). British Journal of General Practice. 2003, 53 (488): 231-9.PubMedPubMedCentral Burton C: Beyond somatisation: a review of the understanding and treatment of medically unexplained physical symptoms (MUPS). British Journal of General Practice. 2003, 53 (488): 231-9.PubMedPubMedCentral
26.
go back to reference Department of Health: Research evidence on the effectiveness of self-care support. 2007, Crown Copyright Department of Health: Research evidence on the effectiveness of self-care support. 2007, Crown Copyright
27.
go back to reference Dunn KM, Croft PR: Classification of low back pain in primary care: using "bothersomeness" to identify the most severe patients. Spine. 2005, 30: 1887-92. 10.1097/01.brs.0000173900.46863.02.CrossRefPubMed Dunn KM, Croft PR: Classification of low back pain in primary care: using "bothersomeness" to identify the most severe patients. Spine. 2005, 30: 1887-92. 10.1097/01.brs.0000173900.46863.02.CrossRefPubMed
28.
go back to reference Blyth FM, March LM, Nicholas MK, Cousins MJ: Self-management of chronic pain: a population-based study. Pain. 2005, 113: 285-92. 10.1016/j.pain.2004.12.004.CrossRefPubMed Blyth FM, March LM, Nicholas MK, Cousins MJ: Self-management of chronic pain: a population-based study. Pain. 2005, 113: 285-92. 10.1016/j.pain.2004.12.004.CrossRefPubMed
29.
go back to reference Richardson A, Ream EK: Self-care behaviours initiated by chemotherapy patients in response to fatigue. Int J Nurs Stud. 1997, 34: 35-43. 10.1016/S0020-7489(96)00031-4.CrossRefPubMed Richardson A, Ream EK: Self-care behaviours initiated by chemotherapy patients in response to fatigue. Int J Nurs Stud. 1997, 34: 35-43. 10.1016/S0020-7489(96)00031-4.CrossRefPubMed
30.
go back to reference Katz PP: Use of self-management behaviors to cope with rheumatoid arthritis stressors. Arthritis Rheum. 2005, 53: 939-49. 10.1002/art.21580.CrossRefPubMed Katz PP: Use of self-management behaviors to cope with rheumatoid arthritis stressors. Arthritis Rheum. 2005, 53: 939-49. 10.1002/art.21580.CrossRefPubMed
31.
go back to reference Kraemer HC, Morgan GA, Leech NL, Gliner JA, Vaske JJ, Harmon RJ: Measures of clinical significance. J Am Acad Child Adolesc Psychiatry. 2003, 42 (12): 1524-9. 10.1097/00004583-200312000-00022.CrossRefPubMed Kraemer HC, Morgan GA, Leech NL, Gliner JA, Vaske JJ, Harmon RJ: Measures of clinical significance. J Am Acad Child Adolesc Psychiatry. 2003, 42 (12): 1524-9. 10.1097/00004583-200312000-00022.CrossRefPubMed
32.
go back to reference R Development Core Team R: A language and environment for statistical computing. 2010, Vienna, Austria: R Foundation for Statistical Computing R Development Core Team R: A language and environment for statistical computing. 2010, Vienna, Austria: R Foundation for Statistical Computing
33.
go back to reference Department of Health: Improving chronic disease management. 2004, The Stationery Office, London Department of Health: Improving chronic disease management. 2004, The Stationery Office, London
34.
go back to reference Last JM: The iceberg - Completing Clinical Picture in General Practice. Lancet. 1963, 2 (729): 28-CrossRef Last JM: The iceberg - Completing Clinical Picture in General Practice. Lancet. 1963, 2 (729): 28-CrossRef
35.
go back to reference Protheroe J, Rogers A, Kennedy AP, Macdonald W, Lee V: Promoting patient engagement with self-management support information: a qualitative meta-synthesis of processes influencing uptake. Implementation Science. 2008, 3: Protheroe J, Rogers A, Kennedy AP, Macdonald W, Lee V: Promoting patient engagement with self-management support information: a qualitative meta-synthesis of processes influencing uptake. Implementation Science. 2008, 3:
36.
go back to reference Townsend A, Wyke S, Hunt K: Frequent consulting and multiple morbidity: a qualitative comparison of 'high' and 'low' consulters of GPs. Fam Pract. 2008, 25 (3): 168-75. 10.1093/fampra/cmn017.CrossRefPubMedPubMedCentral Townsend A, Wyke S, Hunt K: Frequent consulting and multiple morbidity: a qualitative comparison of 'high' and 'low' consulters of GPs. Fam Pract. 2008, 25 (3): 168-75. 10.1093/fampra/cmn017.CrossRefPubMedPubMedCentral
37.
go back to reference Salmon P, Peters S, Stanley I: Patients' perceptions of medical explanations for somatisation disorders: qualitative analysis. BMJ. 1999, 318 (7180): 372-6.CrossRefPubMedPubMedCentral Salmon P, Peters S, Stanley I: Patients' perceptions of medical explanations for somatisation disorders: qualitative analysis. BMJ. 1999, 318 (7180): 372-6.CrossRefPubMedPubMedCentral
38.
39.
go back to reference Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M: Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009, 7 (4): 357-63. 10.1370/afm.983.CrossRefPubMedPubMedCentral Valderas JM, Starfield B, Sibbald B, Salisbury C, Roland M: Defining comorbidity: implications for understanding health and health services. Ann Fam Med. 2009, 7 (4): 357-63. 10.1370/afm.983.CrossRefPubMedPubMedCentral
Metadata
Title
Self-care in people with long term health problems: a community based survey
Authors
Fiona MacKichan
Charlotte Paterson
William E Henley
Nicky Britten
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2011
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-12-53

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