Patients’ and healthcare professionals’ perceptions of self-management support interactions

Systematic review and qualitative synthesis

Marika Franklin, Sophie Lewis, Karen Willis, Helen Bourke-Taylor, Lorraine Smith

Research output: Contribution to journalReview article

25 Citations (Scopus)


Objective To review studies examining the experience of self-management support in patient-provider interactions and the shaping of goals through interactions.

Methods We undertook a systematic review and thematic synthesis of the qualitative literature. We searched six databases (2004-2015) for published studies on the provision of self-management support in one-to-one, face-to-face, patient-provider interactions for obesity, type 2 diabetes mellitus and chronic obstructive pulmonary disease, with 14 articles meeting inclusion criteria.

Results Themes identified from studies were (1) dominance of a traditional model of care, encompassing the provision of generic information, exclusion of the psychosocial and temporal nature of interactions and (2) a context of individual responsibility and accountability, encompassing self-management as patients' responsibility and adherence, accountability and the attribution of blame. Interactions were constrained by consultation times, patient self-blame and guilt, desire for autonomy and beliefs about what constitutes 'effective' self-management.

Discussion Encounters were oriented towards a traditional model of care delivery and this limited opportunity for collaboration. These findings suggest that healthcare professionals remain in a position of authority, limiting opportunities for control to be shared with patients and shared understandings of social context to be developed.
Original languageEnglish
Pages (from-to)79-103
Number of pages25
JournalChronic Illness
Issue number2
Publication statusPublished - Jun 2018
Externally publishedYes


  • chronic conditions
  • chronic obstructive pulmonary disease
  • obesity
  • Patient–provider interactions
  • self-management support
  • type 2 diabetes mellitus

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