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.
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.
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).
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.
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