Living well with a chronic condition: service users’ perspectives of a self-management intervention

Abstract

Aim: The outcomes of self-management interventions (SMIs) for people living with chronic conditions, or long-term conditions (LTCs), are commonly assessed using quantitative measures. Few studies ask people with LTCs to explain, in their own words, what aspects of the intervention they valued. The study aimed to explore the valued features and outcomes of a Health Trainer (HT) service from the perspective of people accessing the service. Methods: The study used Grounded Theory methods to evaluate a HT service in the North of England. Interviews with eight service users were conducted, transcribed and then analysed using initial, focused and theoretical coding. Findings The analysis resulted in the development of a preliminary model, which reflects the findings that the HT service was valued because it contributed to three outcomes: regaining emotional strength and stability; reappraisal of role and identity; and social engagement. Health Trainers performed four related roles that were perceived to contribute to these outcomes: Conceptualizer, Connector, Coach and Champion. Discussion The study proposes a nuanced person-centred interpretation of self-management, which extends well beyond symptom-management or a healthy lifestyle. Living well with a LTC encompasses psychological adjustment, social engagement and adjusted self-identity and life goals. These themes, which are prevalent in other qualitative investigations of self-management, offer a framework for developing and reviewing SMI strategies. Similarly, the roles of the HT identified within this evaluation, suggest a framework for mapping and reviewing the primary functions of SMIs, particularly those that are located within a non-clinical setting.