3 themes described how self care management was learned and experienced by patients with chronic illness

摘要

The qualitative study by Thorne et al adds substantial insight into the perceptions of patienis with chronic iliness about seir care manage ment aimed at improving both quality and length of life. Through c: secondary data analysis technique, the authors astutely identified and contrasted common and diverse themes that defined the self care management experiences of patients with 3 diseases (diabetes, HIV/ AIDS, and multiple sclerosis). The analysis produced new understandings not initially identified through primary analysis of the 2 studies, each of which focused on patients with a single disease. Overall, the secondary data analysis expands knowledge about the nature and structure or chronic disease management. This understanding that many factors, including sociocultural and political factors, influence the self care efficacy of many patients with chronic illness provides clinicians and patients with important information for developing more effective strategies to improve patients' health.Although healthcare providers often use clinical practice guidelines to construct interventions for disease management, the "lived experience' and informed decisions of patients with chronic illness provide clinicians with relevant information that could enhance the appropriateness and efficiency of practice guidelines for chronic diseases. Although clinicians identified patients who met the criterion of being an "expert" (a person with sufficient knowledge of factors influencing their disease ana responsive behaviour to promote or restore their health), many patients did not perceive their knowledge and informed self care behaviours a:-inherent parts of their treatment plans.The findings of Thome ef a/ highlight the need for further research on patients as experts in managing their chronic illnesses. Additional investigation on the influence of gender, length of diagnosis, work, and social support could offer further direction in defining effective anc: appropriate self care treatment strategies used by patients with chronir illness and supported by their clinicians.