Developing a standardized national undergraduate curriculum for future healthcare professionals on self-management support for chronic conditions.

This is a report on the development of the second part of a national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland; National Undergraduate Curriculum for Chronic Disease Prevention and Management Part 2: Self-management Support for Chronic Conditions. The development processes involved in Part 1, Making Every Contact Count for Health Behavior Change, were described earlier. This report presents an overview of the development of a national self-management support curriculum and barriers and enablers encountered. The curriculum was developed by a National Working Group, with interprofessional representation from each of the Higher Education Institutions (HEIs) in Ireland and the national health service, i.e. the Health Service Executive (HSE). All phases of the project were overseen by a Steering Group and supported in each HEI by a local working group. The aim of the curriculum is to introduce standardized self-management support education across all undergraduate and graduate entry healthcare programmes nationally to prepare future healthcare professionals with knowledge, skills and attitudes to support individuals to self-manage their chronic conditions.

Self-care as care left undone? The ethics of the self-care agenda in contemporary healthcare policy.

Self-care, or self-management, is presented in healthcare policy as a precursor to patient empowerment and improved patient outcomes. Alternatively, critiques of the self-care agenda suggest that it represents an over-reliance on individual autonomy and responsibility, without adequate support, whereby 'self-care' is potentially unachievable and becomes 'care left undone'. In this sense, self-care contributes to a blame culture where ill-health is attributed to personal behaviours or lack thereof. Furthermore, self-care may represent a covert form of rationing, as the fiscal means to enable effective self-care and supplement, or replace, self-care capacities, is not provided. This paper explores these arguments through a contemporary ethical analysis of the self-care agenda. The terms self-care and self-management are used interchangeably throughout whereby self-management is understood as a point in the wider self-care continuum.

The challenges to public health nurse practice in rural Ireland.

OBJECTIVES: The primary objective was to understand the contemporary public health nurse's (PHN) role and the issues that they face working in rural Ireland. DESIGN AND SAMPLE: This study was based on an ethnographic approach with 13 PHNs working in rural areas in the South West of Ireland. MEASUREMENTS: A combination of solicited diaries and semi-structured interviews referred to as the diary/interview method were employed. Diaries were used by the PHNs to record their working day on a staggered basis from February to April 2017 with the subsequent interviews carried out in June and July 2017. RESULTS: Working as a PHN in a rural area presented a number of issues such as time spent on traveling as a result of geographical disparity & poor road networks; client transport issues; a sense of working in isolation; communication issues with respect to computer/tablet hardware availability, mobile phone and broadband connectivity and the availability of, and the physical access to services. CONCLUSION: PHNs operating in rural communities face a distinct set of challenges that they have a limited ability to address. Legislators, health care providers and policymakers need to create a supportive environment that helps address these challenges in Ireland.