Self-Management on Chronic Diseases

Purpose:

Chronic disease and its comorbidities represent the cause of episodes of hospitalization for lack of disease control, or its consequences. Ineffective self-management contributes to hospital readmissions and the high number of episodes of specialized care, indicates deficiencies in primary care.

The study purpose was creat an explanatory model on self-management carried out by people with demonstration of ineffectiveness, in order to infer the elements of a health intervention that promotes a responsible self-management.

Methods:

Selected for study were those with chronic illness, with five or more hospitalizations. Twenty-two participants were followed for a maximum of a year and a half, in a multicases study(1). Data were obtained from the analysis of documentation, participant observation and interviews.

The data were analyzed according to the method proposed by Strauss and Corbin, to generate a Grounded Theory(2,3). Beginning with a microanalysis, which was organized in an open coding, than grouping the concepts and their relationships through an axial analysis, and summarizing the data, drawing up theoretical reduction in a selective coding, finally, presenting the theory.

Results:

In this study emerge a pattern of vulnerability with personal and contextual conditions. Socio-economic and cultural poverty arises like the context of greater vulnerability straight by family background(4).

Conclusion:

Analysis of personal circumstances showed that attitude toward life and illness and personal attributes grouped participants in four patterns, which we named as "style": responsible, independent, formally guided and negligent. Some of these conditions are hardly conducive to a healthy transition(5) and Identify the style of self-management can enable nurses to anticipate some difficulties.