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Conceptualisation of the ‘good’ self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions

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Listed:
  • Ellis, J.
  • Boger, E.
  • Latter, S.
  • Kennedy, A.
  • Jones, F.
  • Foster, C.
  • Demain, S.

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.

Suggested Citation

  • Ellis, J. & Boger, E. & Latter, S. & Kennedy, A. & Jones, F. & Foster, C. & Demain, S., 2017. "Conceptualisation of the ‘good’ self-manager: A qualitative investigation of stakeholder views on the self-management of long-term health conditions," Social Science & Medicine, Elsevier, vol. 176(C), pages 25-33.
    • Handle: RePEc:eee:socmed:v:176:y:2017:i:c:p:25-33
    DOI: 10.1016/j.socscimed.2017.01.018
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    References listed on IDEAS

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    1. Campbell, Rona & Pound, Pandora & Pope, Catherine & Britten, Nicky & Pill, Roisin & Morgan, Myfanwy & Donovan, Jenny, 2003. "Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care," Social Science & Medicine, Elsevier, vol. 56(4), pages 671-684, February.
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    Cited by:

    1. Troels Kristensen & Kim Rose-Olsen & Christian Volmar Skovsgaard, 2020. "Effects of Point-Of-Care Testing in General Practice for Type 2 Diabetes Patients on Ambulatory Visits and Hospitalizations," IJERPH, MDPI, vol. 17(17), pages 1-16, August.
    2. Josefien van Olmen, 2022. "The Promise of Digital Self-Management: A Reflection about the Effects of Patient-Targeted e-Health Tools on Self-Management and Wellbeing," IJERPH, MDPI, vol. 19(3), pages 1-9, January.
    3. Simon Fletcher & Stefan Tino Kulnik & Sara Demain & Fiona Jones, 2019. "The problem with self-management: Problematising self-management and power using a Foucauldian lens in the context of stroke care and rehabilitation," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-20, June.
    4. Xie, Julan & Zhou, Dinggen & Tan, Yuxuan, 2021. "Relationship between mindfulness and general health among couples in Mainland China: A crossover perspective," Social Science & Medicine, Elsevier, vol. 281(C).
    5. Felicity Thomas & Lorraine Hansford & Joseph Ford & Katrina Wyatt & Rosemarie McCabe & Richard Byng, 2018. "Moral narratives and mental health: rethinking understandings of distress and healthcare support in contexts of austerity and welfare reform," Palgrave Communications, Palgrave Macmillan, vol. 4(1), pages 1-8, December.

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