Who is in control? Clinicians' view on their role in self-management approaches: a qualitative metasynthesis

aut.relation.startpagee007413
aut.relation.volume5en_NZ
dc.contributor.authorMudge, Sen_NZ
dc.contributor.authorKayes, Nen_NZ
dc.contributor.authorMcPherson, Ken_NZ
dc.date.accessioned2015-07-30T02:22:34Z
dc.date.available2015-07-30T02:22:34Z
dc.date.copyright2015en_NZ
dc.date.issued2015en_NZ
dc.description.abstractObjective To explore clinician perceptions of involvement in delivery of self-management approaches. Setting All healthcare settings. Design EBSCO, Scopus and AMED databases were searched, in July 2013, for peer-reviewed studies in English reporting original qualitative data concerning perceptions of clinicians regarding their involvement in or integration of a self-management approach. Of 1930 studies identified, 1889 did not meet the inclusion criteria. Full text of 41 studies were reviewed by two independent reviewers; 14 papers were included for metasynthesis. Findings and discussion sections were imported into Nvivo-10 and coded line-by-line. Codes were organised into descriptive themes and cross-checked against original sources to check interpretation, and refined iteratively until findings represented an agreed understanding. Studies were appraised for quality. Results Delivering self-management in practice appeared to be a complex process for many clinicians. The issue of ‘control’ arose in all studies, both in the qualitative data and authors’ interpretations. The first theme: Who is in control?—represented ways clinicians talked of exercising control over patients and the control they expected patients to have over their condition. The second theme: Changing clinician views—reflected what appeared to be an essential transformation of practice experienced by some clinicians in the process of integrating self-management approaches into the practice. A range of challenges associated with shifting towards a self-management approach were reflected in the third theme, Overcoming challenges to change. Tensions appeared to exist around forming partnerships with patients. Strategies found helpful in the process of change included: dedicating time to practice reciprocity in communication style, peer support and self-reflection. Conclusions A consistent finding across studies is that ‘control’ is a key feature of how self-management is viewed by clinicians. They described challenges associated with the paradigm shift required to share or let go of control. Future research should identify whether strategies described by clinicians are key to successful self-management.en_NZ
dc.identifier.citationBMJ Open 2015; 5:e007413; doi:10.1136/bmjopen-2014-007413en_NZ
dc.identifier.doi10.1136/bmjopen-2014-007413en_NZ
dc.identifier.issn2044-6055en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/8998
dc.languageengen_NZ
dc.publisherBMJ Open
dc.relation.urihttp://dx.doi.org/10.1136/bmjopen-2014-007413
dc.rightsThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectHealth occupationsen_NZ
dc.subjectProfessional practiceen_NZ
dc.subjectSelf-managementen_NZ
dc.titleWho is in control? Clinicians' view on their role in self-management approaches: a qualitative metasynthesisen_NZ
dc.typeJournal Article
pubs.elements-id183163
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
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