Promoting self-care through symptom management: a theory-based approach for nurse practitioners.
OBJECTIVE
To present a theory of illness representation useful in clinical practice along with two case studies as examples of theory implementation.


METHODS
Literature review of relevant theory and associated literature, case studies from clinical practice.


CONCLUSIONS
An individual asks several questions when experiencing a physical sensation: "Am I sick, stressed, or is this a sign of aging? If I'm sick, is the symptom connected with a disease label?" After asking these questions, the individual develops a cognitive and emotional illness representation that includes the dimensions of identity, cause, consequences, control, and timeline. This representation is guided by personal, cultural, and environmental contexts and determines coping strategies. By assessing the individual's cognitive and emotional representations of the illness, the nurse practitioner (NP) can use the common sense model of illness representation (CSM) to establish interventions and action plans helpful in decreasing distress in the management of symptoms.


CONCLUSIONS
NPs frequently care for patients who present with very severe symptoms related to their health problem. This becomes a major challenge in effective disease management. Leventhal's CSM can be used as a framework to identify the cognitive and emotional illness representations individuals develop when acute and chronic symptoms are presented. By assessing the individual's cognitive and emotional representations of the illness, the NP will be able to use the CSM to establish interventions and action plans that will be helpful in decreasing the patient's distress in the management of symptoms.
Fowler
Christopher
C
Liver Institute at Methodist Dallas Medical Center, Dallas, Texas, USA. christopher.fowler@sbcglobal.net
Kirschner
Michelle
M
Van Kuiken
Debra
D
Baas
Linda
L
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001364:Awareness; D015984:Causality; D003071:Cognition; D003657:Decision Making; D019468:Disease Management; D004644:Emotions; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D016294:Models, Nursing; D008960:Models, Psychological; D009722:Nurse Practitioners / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment; D010347:Patient Care Planning / Q000458:organization & administration; D011340:Problem Solving; D012648:Self Care / Q000379:methods / Q000523:psychology