title: Problem solving in diabetes self-management: a model of chronic illness self-management behavior.
abstract: Management of chronic illnesses is a significant public health concern that is made more challenging by problems of regimen adherence. Effective self-management of chronic illnesses such as diabetes requires not only technical skill to perform regimen behaviors but also problem-solving skills to manage daily barriers to regimen adherence and to make appropriate adjustments to the self-care regimen. A review of the empirical literature on the relation between problem solving and disease self-management in diabetes, a chronic illness exemplar, illuminates methodological limitations that indicate a need for a theoretical framework for problem solving applied to chronic disease self-management. A problem-solving model of chronic disease self-management is proposed, derived from theories of problem solving in cognitive psychology, educational/learning theory, and social problem solving. Four essential components of problem solving in disease self-management are identified: (a). problem-solving skill, (b). problem-solving orientation, (c). disease-specific knowledge, and (d). transfer of past experience. The model is illustrated, and empirical support for this problem-solving model in the diabetes literature is discussed. The model has utility in driving testable hypotheses regarding the relation of disease-specific problem solving to chronic illness management, in developing problem-solving assessment instruments relevant to disease self-management, and in guiding disease self-management training and interventions.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. fbriggsh@jhmi.edu
authors.forename: Felicia
authors.initials: F
authors.lastname: Hill-Briggs
mesh_terms: D001294:Attitude to Health; D002908:Chronic Disease; D006801:Humans; D011340:Problem Solving; D011582:Psychological Theory; D012648:Self Care; D012803:Sick Role