Abstract

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Chronic condition self-management is a health system construct, designed to achieve optimal clinical health outcomes through symptom control and patient adherence to treatment. Government policy from many countries are urging a transformation in how healthcare systems deliver care for people living with long term conditions that is more inclusive of their personal experience, yet there is little evidence of this change in practice. Biomedical approaches continue to predominate, despite the lack of evidence for the efficacy of medically driven approaches to chronic condition self-management. The sociological literature richly describes how people manage their lives when faced with a long term condition. Concepts such as ‘biographical disruption’, ‘new normal’, and the ‘lived experience’ all attest to the importance of taking into account more than a medically defined focus on outcomes, and a need to understand patients’ priorities. There is an expectation that people with long term conditions should have the knowledge and skills to effectively self-manage their condition, but the extent to which people are able to this overwhelmingly depends on their embodied experience of illness, the extent of disruption to their everyday lives, their health beliefs and social patterns such as education, social class, gender, ethnicity, and age. From a psychological perspective, learning how to self-manage requires complex skills and knowledge in order to effectively engage in the process of self-management, but these skills are not always of interest to the individual or seen as personally relevant. What prevails is an intricate situation where current healthcare approaches to long term condition self-management cannot take into account the complex social and psychological factors at play in interactions between HCPs and those living with chronic conditions.

This problem may be understood through examining the competing imperatives of healthcare policy, the person living with a chronic condition and healthcare providers, through both a sociological as well as a psychological lens. We are seeking contributions on the following areas for a lively and engaging discussion regarding:

• Exploration of the tensions between government driven healthcare initiatives promoting self-management of long-term conditions and the implied imperative that individuals must ‘take control’ of their condition.

• Understanding the alignment and the points of difference between healthcare providers’ and patients’ goals for long term condition self-management.

• What is the nature of the interactions between healthcare providers and their patients and how are approaches to treatment for long term conditions negotiated?

• What are users’ (participants and facilitators) experiences of programs for chronic condition self-management?

• Exploration of the challenges inherent in attempting to bring together sociological and psychological perspectives regarding self-management of long term conditions.

• The paradox of healthcare providers’ expectations of patient self-management alongside the relinquishing of expert knowledge and power.

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Session organizer(s)

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Lorraine Smith (AU) – Associate Professor Lorraine is a social scientist at the University of Sydney. Her research focuses on patient perspectives of self-management of long term conditions, with a particular focus on goal setting. She is currently leading an Australian Research Council funded social-psychological study into how healthcare providers and their patients enact and negotiate long term condition self-management goals.

 

Sophie Lewis (AU) – is a Senior Research Fellow within the School of Social Sciences at the University of New South Wales, Sydney. Her research broadly focuses on sociological understandings of the experiences of living with long term conditions including cancer and obesity. Her current research looks at the ways people navigate the Australian healthcare system and make choices about public and private health service; how social interactions and social context enable people to manage chronic conditions; and the lived experience of advanced cancer.

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