Characteristics of a self-management support programme applicable in primary health care: a qualitative study of users' and health professionals' perceptions.

BACKGROUND: Development of more self-management support programmes in primary health care has been one option used to enhance positive outcomes in chronic disease management. At present, research results provide no consensus on what would be the best way to develop support programmes into new settings. The aim of the present study was therefore to explore users' and health professionals' perceptions of what would be the vital elements in a self - management support programme applicable in primary health care, how to account for them, and why. METHODS: Four qualitative, semi-structured focus group interviews were conducted in Central Norway. The informants possessed experience in development, provision, or participation in a self-management support programme. Data was analysed by the Systematic Text Condensation method. RESULTS: The results showed an overall positive expectation to the potential benefits of development of a self-management support programme in primary health care. Despite somewhat different arguments and perspectives, the users and the health professionals had a joint agreement on core characteristics; a self-management support programme in primary health care should therefore be generic, not disease specific, and delivered in a group- based format. A special focus should be on the everyday- life of the participants. The most challenging aspect was a present lack of competence and experience among health professionals to moderate self-management support programmes. CONCLUSIONS: The development and design of a relevant and applicable self-management support programme in primary health care should balance the interests of the users with the possibilities and constraints within each municipality. It would be vital to benefit from the closeness of the patients' every-day life situations. The user informants' perception of a self-management support programme as a supplement to regular medical treatment represented an expanded understanding of the self-management support concept. An exploring approach should be applied in the development of the health professionals' competence in practice. The effect of a self-management support programme based on the core characteristics found in this study needs to be evaluated.

Reasons for participation in group-based type 2 diabetes self-management education. A qualitative study.

AIMS: To investigate reasons for participating in group-based diabetes self-management education (DSME) for patients with type 2 diabetes. METHODS: A qualitative study using focus groups and individual semi-structured interviews was conducted with 22 patients attending seven different groups in Central Norway. RESULTS: Patients with diabetes described two main reasons for attending DSME; experiencing practical problems and feeling insecure. These reasons differed by affecting the patients in two ways - practically or emotionally. Practical problems and feeling insecure both originated from lack of or contradictory information and from lack of contact with other patients with diabetes. This affected the patients' everyday lives in important areas such as diet, medication, social settings and lifestyle changes. CONCLUSIONS: The underlying reason for participating in a DSME was the participants' experience of having insufficient information about their diabetes, which led to practical problems and emotional insecurity. Being aware of the patients' reasons for participating can help professionals keep a focus which is more consistent with patients' needs.