Wednesday, 13 June 2012

Promoting Optimal Self-Care

I have been lent a copy of "Promoting Optimal Self Care: Consultation techniques that improve quality of life for patients and clinicians" produced by the Dorset and Somerset Strategic Health Authority (2006). It was really interesting to read and has some very good points on self-care.

  • Self-care is not the same as no care - this is  an important selling point for patients, who may feel the doctor is dis-owning them!
  • Outside of hospitals everyone self-cares, but not everyone self-cares optimally
  • Optimising the capacity's to self-care means helping people to manage change by using an appropriate consultation style that addresses health-related benefits and expectations and promotes activity - activity is really important, especially when patients can feel trapped in inertia with their condition
  • People only optimally self-care once they know that their medical condition is optimally managed - self-care is not the first option after a diagnosis and doctors need to do their bit first!
  • Biopsychosocial domains: considering and assessing all three is really important
  • Health-related beliefs and expectations are strong predictors of quality of life - why is more attention not paid to them then?!?!
  • Many people develop health-related anxiety as a result of misconceived beliefs and expectations - highlights the importance of information!
  • Many people continue to live their lives, expecting themselves to be the person they were before the onset of their disorder. Being unable to live up to this expectation can lead to worsening of symptoms, anger and frustration. People need reasonable goals and a 'desired future self' that is attainable - I know it hard to get the  bottom of these issues in an appointment, but doctors should be aware of the issues and begin to address them, or signpost to someone who has the time to address them properly!
The whole book is fascinating, and quite encouraging to read, as it is written by doctors for doctors. Implementing the principles of motivational interviewing and promoting optimal self-care are more difficult in the time-poor setting of a consultation. Overall, a great self-management resource, but still leaves me wondering how to guarantee up-take on the ideas by doctors?!


  1. I promise I'll stop commenting soon, but your blog is fascinating! I may be biased (well I am because I'm a coach :-)), but I think one good way is through using coaching with doctors. Teaching peole how to see patients/clients/whoever as their own experts on themselves, holding fast to the belief that people can be helped to find their own answers within - asking the right questions, staying really curious about the answers and nor presupposing the outcomes, developing relationships where patients and doctor are contributing their own area of expertise - would that be a start?

    1. Yes, that would be an excellent start - helping patients to help themselves! And shared decision making too . . . Valuing expertise is key, and something I am preparing a blogpost on at the moment!
      It comes down to effective shared decision making - holistic options ....