c38 journey into well being[1]
TRANSCRIPT
Journey Into Well-Being:
The Path to Positive Self Management of Chronic Disease
OBJECTIVES:
1.To understand the concept of self management in Chronic Disease Management
2. To learn the tasks and skills required to self manage
3. To introduce NYGH ‘s Chronic Disease Self Management Program, Journey Into Well-Being
4. To experience elements of group skill mastery
5. To discover how CDSMP fits into the Community Health Centre
Reflect…..
Knowledge =?= Behavior Change
ACUTE DISEASE
abrupt onset short termsingle causediagnosis certainintervention usually effectiveoutcome cure commonuncertainty minimalknowledge of professional important
Chronic Disease
gradual onsetlong termmany causes, interrelateddelayed diagnosismultiple interventions, side effects, no effectsno cure…..managementuncertain futureknowledge of patient and professional important
Traditional Education Self ManagementEducation
Professional is expert in diseaseProfessional tells patient what to do and sets goalsProfessional solves the problemsGoal is for patient to comply to professional to achieve benefitsBehaviour changed by external motivation
Minimal behavior change occurs.
Patient is the expert in their livesPatient sets goals with professionalPatient identifies problemsPatient learns strategies to solve problemsPatient internally motivated and uses problem solving, goals to achieve benefits that are meaningful
Maximal behaviour change occurs
Self Management Tasks
Medical management of condition(s)
Managing changing life roles
Dealing with difficult emotions
Self Management Skills
Problem solvingDecision makingResource utilizationPatient/ health care provider partnershipTaking action (achieving meaningful goals)
Action Planning
1. Something YOU want to do2. Achievable3. Action specific4. Answers the questions:
What?How much?When?How often?
5. Confidence level of 7/10 or more(Stanford CDSMP)
Benefits of Self Management programs
Increased use of healthy behaviours
relaxation, exercise, healthy eating, stress management
Improved health status
Reduced health care utilization
1:9
Why do self management programs work?
Self Efficacy Theory:When patients have the confidence to do something, they will probably do it (Bandura)
skills masterymodellingreinterpretation of symptomssocial persuasion
INDIVIDUALS AND FAMILIES
Improved clinical, functionaland population health outcomes
HEALTH CAREORGANIZATIONS
Informed,activated
individuals& families
Prepared, proactivepracticeteams
Activated communities &
prepared, proactivecommunity
partners
HealthyPublicPolicy
SupportiveEnvironments
CommunityAction
DeliverySystemDesign
ProviderDecisionSupport
InformationSystems
Ontario’s CDPM Framework
Productive interactions and relationships
PersonalSkills & Self-Management
Support
INDIVIDUALS AND FAMILIES
Improved clinical, functionaland population health outcomes
HEALTH CAREORGANIZATIONS
Informed,activated
individuals& families
Prepared, proactivepracticeteams
Activated communities &
prepared, proactivecommunity
partners
HealthyPublicPolicy
SupportiveEnvironments
CommunityAction
DeliverySystemDesign
ProviderDecisionSupport
InformationSystems
Ontario’s CDPM Framework
Productive interactions and relationships
PersonalSkills & Self-Management
Support
Journey Into Well-beingThe Chronic Disease Self Management Program
Stanford (Lorig) modelLicensed programNo doctor’s referral neededTarget: 50+ with any chronic disease
diabetes, asthma, hypertension, arthritis, osteoporosis, depression
6 weeks, 2 ½ hoursRelaxation, nutrition, exercise, action plans
$25 (Reference book)
2 leaders: 1 Lay leader, 1 Health Care Professional
(4 day training for leaders)Scripted sessions –emphasis on group process, setting and achieving goals, learning from others
CDSMP in the CHC
Need for CDM programmingCommunity – staff relationshipLocationsExisting programsOngoing support
Disease specific informationExercise
Other opportunities