A thematic analysis of the conceptualisation of self-care, self-management and self-management support in the long-term conditions management literature

Aim. To conduct a thematic analysis of the conceptualisation of self-care in the chronic illness management literature. Background. The growing prevalence of chronic illness is an increasing challenge for health and social-care services that attempt to better support self-care and self-management. There is currently a lack of consensus about the meaning and usage of these terms in a rapidly expanding research and policy literature. This may hinder the service innovation based on such policy imperative and evidence. Methods. An iterative literature search was performed, across a wide variety of research databases, using the existing subject headings ‘self-care’ and ‘chronic disease’. Publications (1995–2008) were included if they had a primary focus on self-care or self-management of a long-term condition and provided some form of definition for these concepts. Publications were subject to systematic data extraction and subsequent thematic analysis. Results. The search resulted in 1469 publications, of which 247 were included. Publications represented a wide range of quantitative and qualitative designs focused on several long-term condition areas. Definitions of self-care (SC), self-management (SM) and self-management support (SMS) were multidimensional and varied as to who is involved, what is entailed and what is achieved. Whilst overlap exists, it is the nature of the networks involved (broad, focused or co-ordinated), the imperative for action (optional, unavoidable or essential), and the goals to be achieved (maintenance, coping or facilitation) that conceptually distinguish self-care, self-management and self-management support. Conclusions. Definitions of self-care, self-management and self-management support are complex and multidimensional. Key conceptual distinctions can be made between these terms suggesting that they can be applied with greater consistency and precision in practice, policy and research. Relevance to clinical practice. Future research must use these terms with greater precision to allow comparisons of the differential effectiveness of intervention programmes in long-term conditions