Entete 3

Challenges of self-management when living with multiple chronic conditions



By Clare Liddy

In our systematic review of the qualitative literature examining the patient’s perspectives of living with multiple chronic conditions published in Canadian Family Physician [1], we found that patients were able to clearly identify challenges associated with self-management and develop strategies to address these factors. The barriers to self-management are many and yet common between people with many different diseases. However, while most studies were disease-specific, we found that discussion among patients that related to specific medical conditions and disease-specific symptoms was strikingly absent. People did not complain about lack of skill to manage medical tasks such as injecting insulin or blood pressure monitoring; rather, they reported difficulties in dealing with physical and emotional symptoms, with depression, pain and fatigue being prominent. In addition, issues related to knowledge about self-management of conditions commonly arose because of confusing and often contradictory information provided by multiple health care providers. The use of cognitive strategies including reframing, prioritizing, and changing beliefs was reported to improve people’s ability to self-manage their multiple chronic conditions.
This study provides a unique view into the patients’ perspectives of living with multiple chronic conditions which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with the patient’s perspectives of living with multiple chronic conditions and this may be achieved by ensuring a more patient-centered approach is adopted by providers and health service organizations.

1. Liddy, C., Blazkho, V. & Mill, K. (2014). “Challenges of self-management when living with multiple chronic conditions. Systematic review of the qualitative literature.” Canadian Family Physician, 60, 1123-1133.

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