title: Patients' perceived barriers to active self-management of chronic conditions.
abstract: Few studies have elicited barriers to patient self-management of chronic conditions, and only one concerned people with two or more conditions. To inform development of Homing in on Health (HioH), a home delivery variant of the Chronic Disease Self-Management Program (CDSMP), we conducted 10 focus groups involving 54 chronically ill people, 46 (85%) of whom had multiple conditions. The goals were to elicit perceived barriers to active self-management and to accessing self-management support resources. Depression, weight problems, difficulty exercising, fatigue, poor physician communication, low family support, pain, and financial problems were the most frequently noted barriers to active self-management. The most common barriers to accessing self-management support resources were lack of awareness, physical symptoms, transportation problems, and cost/lack of insurance coverage. Our findings provided initial support for the Homing in on Health approach, since many of the barriers identified may be more amenable to home-based intervention than to centralized, facility-based programs.
authors.affiliation: Department of Family and Community Medicine, University of California Davis, School of Medicine, 4860 Y Street, Suite 2300, Sacramento, CA 95818, USA. afjerant@ucdavis.edu
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Jerant
authors.forename: Marlene M
authors.initials: MM
authors.lastname: von Friederichs-Fitzwater
authors.forename: Monique
authors.initials: M
authors.lastname: Moore
mesh_terms: D002140:California; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D003144:Communication Barriers; D019468:Disease Management; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards; D006304:Health Status; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000458:organization & administration*; D010347:Patient Care Planning; D010353:Patient Education as Topic / Q000592:standards; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D011340:Problem Solving; D036301:Qualitative Research; D012648:Self Care / Q000379:methods / Q000523:psychology* / Q000592:standards; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D014186:Transportation