Self-management support

As a nation responding to the significant challenges of a pandemic and all of us having to manage numerous new ways of working – it has also been a valuable time to reflect on the important and critical role of self-management support.

Contrary to some patients’ perceptions ‘self-management’ doesn’t mean being left to get on with things on your own (DIY!) nor does it simply mean patients complying with set advice from a professional. I prefer the idea of self-management ‘support’, which is a tailored and personalised approach. The start point is the individual patient, their needs, ideas, goals and the premise that patients can and do already have many skills and resources. This helps enable partnership working from the outset and for patients to gain confidence, freedom to experiment and discover new ways of managing. 

Successful self-management support leaves patients feeling more confident

It’s also helpful to focus on self-efficacy (or confidence in our own ability) which can go up and down. Someone with low self-efficacy such as ‘Liz’, a Covid-19 survivor recently discharged from hospital, told us she felt ‘lost, fatigued and overwhelmed’. When we asked what the most important thing was for her, she said ‘I just want the energy to get back to playing silly games with my family’. Acknowledging what drives her is an important starting point and then encouraging her to reflect on her achievements so far, however small, can really help to change self-efficacy and build belief so that she can see a way forward. It’s a change that can be easier to support than all of us might think. 

By listening to and doing research with many rehabilitation teams, patients and families over the years I know that successful self-management support leaves patients feeling more confident, valued and knowledgeable about what they can do to help themselves. Not a bad outcome from rehabilitation really.

• Fiona Jones is professor of rehabilitation research at St George’s University