Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy Program, Ghent University, Ghent, Belgium.
Occupational Therapy, Artevelde University College, Ghent, Belgium.
BMJ Open. 2019 Jul 16;9(7):e027775. doi: 10.1136/bmjopen-2018-027775.
Self-management is a concept frequently used within healthcare but lacks consensus. It is the aim of this study to clarify the concept.
Concept analysis according to Walker and Avant, comprises eight steps: select concept, determine purpose, identify uses, determine defining attributes, identify model case, identify additional cases, identify antecedents and consequences and define empirical referents.
PubMed, Scopus and Web of Science.
Ten attributes delineating the concept have been identified and organised into three groups. Group (a): person-oriented attributes: the person must (1) actively take part in the care process, (2) take responsibility for the care process and (3) have a positive way of coping with adversity. Group (b): person-environment-oriented attributes: (4) the person must be informed about the condition, disease and treatment and self-management, (5) should be individualised, which entails expressing needs, values and priorities, (6) requires openness to ensure a reciprocal partnership with healthcare providers and (7) demands openness to social support. Finally, Group (c): summarising attributes: self-management (8) is a lifetime task, (9) assumes personal skills and (10) encompasses the medical, role and emotional management.
The findings of this study recognise the complexity of the concept, but also show the need for further investigation to make the concept more measurable. Clarity about the concept will enhance understanding and facilitate implementation in self-management programmes for chronic conditions.
自我管理是医疗保健领域中经常使用的一个概念，但缺乏共识。本研究旨在阐明这一概念。
根据沃克和奥凡特的概念分析，包括八个步骤：选择概念、确定目的、确定用途、确定定义属性、确定典型案例、确定附加案例、确定先行条件和后果以及定义经验参照。
PubMed、Scopus 和 Web of Science。
确定了 10 个界定概念的属性，并将其组织成三组。组 (a)：以人为导向的属性：个人必须 (1) 积极参与护理过程，(2) 对护理过程负责，(3) 以积极的方式应对逆境。组 (b)：人与环境导向的属性：(4) 个人必须了解病情、疾病和治疗以及自我管理，(5) 应该个体化，这需要表达需求、价值观和优先级，(6) 需要开放以确保与医疗保健提供者建立互惠伙伴关系，(7) 需要开放以获得社会支持。最后，组 (c)：总结属性：自我管理 (8) 是一项终身任务，(9) 需要个人技能，(10) 包括医疗、角色和情感管理。
本研究的结果认识到该概念的复杂性，但也表明需要进一步研究，以使该概念更具可衡量性。明确这一概念将提高对其的理解，并有助于在慢性病自我管理计划中实施。
