Hale Leigh, Wilkinson Amanda, Pilusa Sonti, Stewart Aimee
Department of Physiotherapy, Faculty of Health Sciences, University of Otago, Dunedin, New Zealand.
Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
S Afr J Physiother. 2024 Apr 30;80(1):1978. doi: 10.4102/sajp.v80i1.1978. eCollection 2024.
Self-management is an important strategy to improve quality of life, appropriately manage long-term health conditions, and reduce the economic burden of long-term health conditions. However, equitable healthcare access remains an issue, and the focus on 'self' in self-management is problematic. Our review aims to explore the conceptualisation and evolution of supported self-management in an African context and its relevance to physiotherapy. A state-of-the-art review of the literature was undertaken by the authors. The authors knowledge of the subject area and a database search retrieved recent articles exploring patients' and healthcare providers' understanding of supported self-management in Africa. Relevant articles were read, and data summaries of included studies were extracted and tabulated. Findings were organised deductively. Sixteen studies, 11 primary research, and 5 reviews (2016-2023) undertaken in a variety of sub-Saharan countries with healthcare workers (~ = 177) and people (~ = 16 115) living with a mix of non-communicable and communicable conditions were considered in this state-of-the-art review. Self-management perceptions were drawn from Western authors spanning development research and understanding of the concepts in Western thinking. We conclude that imported concepts, such as supported self-management for long-term conditions, should be considered within local health delivery solutions. These should be embedded in an understanding of traditional African health systems.
There is a need to develop locally derived African solutions. Self-management strategies for long-term health conditions should be developed, considering traditional holistic African health systems.
自我管理是提高生活质量、妥善管理长期健康状况以及减轻长期健康状况经济负担的重要策略。然而，公平获得医疗保健仍然是一个问题，而且自我管理中对“自我”的关注存在问题。我们的综述旨在探讨非洲背景下支持性自我管理的概念化和演变及其与物理治疗的相关性。作者对文献进行了最新综述。作者凭借对该主题领域的了解并通过数据库搜索，检索到了近期探讨非洲患者和医疗服务提供者对支持性自我管理理解的文章。阅读了相关文章，并提取了纳入研究的数据摘要并制成表格。研究结果进行了演绎整理。在本次最新综述中，考虑了在撒哈拉以南非洲各国开展的16项研究，其中11项为原发性研究，5项为综述（2016 - 2023年），涉及医疗工作者（约177名）以及患有非传染性和传染性疾病的人群（约16115名）。自我管理观念源自西方作者，涵盖发展研究以及西方思维中对这些概念的理解。我们得出结论，诸如针对长期病症的支持性自我管理等舶来概念，应在当地卫生服务解决方案中予以考量。这些方案应建立在对非洲传统卫生系统的理解基础之上。
有必要制定源自非洲本土的解决方案。在考虑非洲传统整体卫生系统的情况下，应制定针对长期健康状况的自我管理策略。
