Frameworks for self-management support for chronic disease: a cross-country comparative document analysis

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dc.contributor.author O'Connel, Selena
dc.contributor.author Mc Carthy, Vera J. C.
dc.contributor.author Savage, Eileen
dc.date.accessioned 2018-08-29T15:47:19Z
dc.date.available 2018-08-29T15:47:19Z
dc.date.issued 2018
dc.identifier.citation O’Connell, S., Mc Carthy, V. J. C. and Savage, E. (2018) 'Frameworks for self-management support for chronic disease: a cross-country comparative document analysis', BMC Health Services Research, 18(1), 583 (10pp). doi: 10.1186/s12913-018-3387-0 en
dc.identifier.volume 18
dc.identifier.startpage 1
dc.identifier.endpage 10
dc.identifier.issn 1472-6963
dc.identifier.uri http://hdl.handle.net/10468/6660
dc.identifier.doi 10.1186/s12913-018-3387-0
dc.description.abstract Background: In a number of countries, frameworks have been developed to improve self-management support (SMS) in order to reduce the impact of chronic disease. The frameworks potentially provide direction for system-wide change in the provision of SMS by healthcare systems. Although policy formulation sets a foundation for health service reform, little is currently known about the processes which underpin SMS framework development as well as the respective implementation and evaluation plans. Methods: The aim of this study was to conduct a cross-country comparative document analysis of frameworks on SMS for chronic diseases in member countries of the Organisation for Economic Cooperation and Development. SMS frameworks were sourced through a systematic grey literature search and compared through document analysis using the Health Policy Triangle framework focusing on policy context, contents, actors involved and processes of development, implementation and evaluation. Results: Eight framework documents published from 2008 to 2017 were included for analysis from: Scotland, Wales, Ireland, Manitoba, Queensland, Western Australia, Tasmania and the Northern Territory. The number of chronic diseases identified for SMS varied across the frameworks. A notable gap was a lack of focus on multimorbidity. Common courses of action across countries included the provision of self-management programmes for individuals with chronic disease and education to health professionals, though different approaches were proposed. The 'actors' involved in policy formulation were inconsistent across countries and it was only clear from two frameworks that individuals with chronic disease were directly involved. Half of the frameworks had SMS implementation plans with timelines. Although all frameworks referred to the need for evaluation of SMS implementation, few provided a detailed plan. Conclusions: Differences across frameworks may have implications for their success including: the extent to which people with chronic disease are involved in policy making; the courses of action taken to enhance SMS; and planned implementation processes including governance and infrastructure. Further research is needed to examine how differences in frameworks have affected implementation and to identify the critical success factors in SMS policy implementation. en
dc.description.sponsorship Health Service Executive (Programme for Health Service Improvement) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central en
dc.relation.uri https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3387-0
dc.rights © 2018, the Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/
dc.subject Document analysis en
dc.subject Health policy analysis en
dc.subject Self-management support en
dc.subject Chronic disease en
dc.title Frameworks for self-management support for chronic disease: a cross-country comparative document analysis en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Selena O’Connell, Nursing & Midwifery, University College Cork, Cork, Ireland +353-21-490-3000, Email: selena.oconnell@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Service Executive
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Health Services Research en
dc.internal.IRISemailaddress selena.oconnell@ucc.ie en
dc.identifier.articleid 583


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© 2018, the Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © 2018, the Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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