ABSTRACT
Healthcare policy in developed countries has, in recent years, promoted self-management among people with long-term conditions. Such policies are underpinned by neoliberal philosophy, as seen in the promotion of greater individual responsibility for health through increased support for self-management. Yet still little is known about how self-management is understood by commissioners of healthcare services, healthcare professionals, people with long-term conditions and family care-givers. The evidence presented here is drawn from a two-year study, which investigated how self-management is conceptualised by these stakeholder groups. Conducted in the UK between 2013 and 2015, this study focused on three exemplar long-term conditions, stroke, diabetes and colorectal cancer, to explore the issue. Semi-structured interviews and focus groups were carried out with 174 participants (97 patients, 35 family care-givers, 20 healthcare professionals and 22 commissioners). The data is used to demonstrate how self-management is framed in terms of what it means to be a 'good' self-manager. The 'good' self-manager is an individual who is remoralised; thus taking responsibility for their health; is knowledgeable and uses this to manage risks; and, is 'active' in using information to make informed decisions regarding health and social wellbeing. This paper examines the conceptualisation of the 'good' self-manager. It demonstrates how the remoralised, knowledgeable and active elements are inextricably linked, that is, how action is knowledge applied and how morality underlies all action of the 'good' self-manager. Through unpicking the 'good' self-manager the problems of neoliberalism are also revealed and addressed here.
Subject(s)
Disabled Persons/psychology , Disease Management , Health Personnel/psychology , Self Efficacy , Self-Management/psychology , Adolescent , Adult , Caregivers/psychology , Colorectal Neoplasms/psychology , Colorectal Neoplasms/therapy , Diabetes Mellitus/psychology , Diabetes Mellitus/therapy , Female , Health Policy/trends , Humans , Male , Middle Aged , Qualitative Research , Self-Management/methods , Stroke/psychology , Stroke/therapy , United KingdomABSTRACT
This article discusses the manual handling risks associated with lifting patients' legs and describes equipment designed to minimise these risks. The findings of an evaluation of leg lifters are summarised and the potential benefits and limitations of this equipment for nursing practice are highlighted.