A lot of studies in the field of self-management interventions use group settings to demonstrate efficacy. Clinical practice on the other side is often done in one-on-one consultations, and chronically ill persons have their own ways to self-manage their illnesses.
I'm interested in your experiences in tailoring interventions from research, in approaches that work best in your clinical practice with chronically ill patients.
Hi Robert,
I fully agree with what you write in your question. I work with Professor Fiona Jones here at Kingston University and St George's, University of London, UK, and I think that her work might be of interest to you.
Fiona is a leading academic in the field of self-management support for people with complex and multiple long-term conditions. Based on her work over the past ten years, Fiona has developed Bridges Self-Management, an approach that integrates self-management support into the everyday one-to-one interactions between health professionals and patients, so it is not a stand-alone group programme like many other self-management programmes that are on offer.
This work began in stroke rehabilitation, and has now developed to become more generic and applicable in patients with different and multiple long-term (chronic) conditions. Recent projects included patients with traumatic brain injury, multiple sclerosis, Parkinson's disease, dementia, and other conditions. Fiona also runs a well established training programme for health professionals in how to support patients' self-management skills.
Our website will give you a good overview of Fiona's work, as well as links to recent research projects and publications: www.bridgesselfmanagement.org.uk
To answer your question: Bridges Self-Management provides an evidence-based solution to tailoring self-management interventions to the needs of individual patients, by using a well-developed methodology based on co-production, person-centredness and partnership working between health professional and patient.
I hope this is helpful to you, please feel free to get in touch should you have any queries or wish to discuss further,
Best wishes
Tino
Personalizing health self-management has become possible. Healthcare has advanced from the outdated "one size fits all"/ "doctor-knows-all" kind of historical Hippocratic approaches to more efficacious, equitable, accessible, affordable, and data-driven methods which ultimately put the locus-of-control back to the sufferer rather than giving away the most valuable resource one can have - his/her health. Quantification of self-tracking, lifestyle modifications, real-time self-monitoring, and sequencing genomes, u-biomes, -omics, all need to be combined to address health conditions which have all complex factors, in today's post medical era. Health research and new knowledge is doubling almost every 2-3 years. One can sequence his/her own genome for just a couple of hundred dollars, and a lot more. We have a start-up addressing these issues, link here propriahealth.com
One study (Bassett and Prapavessis, 2007) on physical therapy for ankle sprains showed that the home-based groups had similar outcome scores for post-treatment ankle function, adherence and motivation to a standard physical therapy intervention. However, the home-based group had significantly better attendance at clinic appointments and a better physical therapy completion rate. Patients were helped to set goals and to develop personal action plans to complete the therapy as well as education and skills training on the treatment such as strapping techniques. The patients had more control and were better informed about their recovery and this sharing of knowledge and skills led to a viable home-based option. Nevertheless, self-care can be a complicated issue that is not appropriate for all situations or people and the importance of arranging for patients to choose the nature or timing of treatment, or teaching them 'coping skills' in groups has shown variable results.
Clinically, I have developed a biomarker for retinal blood flow. I use the results of this analysis to determine how many of three successful interventions to use,
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