title: What motivates Australian health service users with chronic illness to engage in self-management behaviour?
abstract: BACKGROUND
  Health policy in Australia emphasizes the role of health service users (HSU) in managing their own care but does not include mechanisms to assist HSUs to do so.
  
  
  OBJECTIVE
  To describe motivation towards or away from self-management in a diverse group of older Australians with diabetes, chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) and suggest policy interventions to increase patient motivation to manage effectively.
  
  
  METHODS
  Content and thematic analyses of in-depth semi-structured interviews. Participants were asked to describe their experience of having chronic illness, including experiences with health professionals and health services. Secondary analysis was undertaken to expose descriptions of self-management behaviours and their corresponding motivational factors.
  
  
  METHODS
  Health service users with diabetes, COPD and/or CHF (N=52).
  
  
  RESULTS
  Participant descriptions exposed internal and external sources of motivation. Internal motivation was most often framed positively in terms of the desire to optimize health, independence and wellness and negatively in terms of avoiding the loss of those attributes. External motivation commonly arose from interactions with family, carers and health professionals. Different motivators appeared to work simultaneously and interactively in individuals, and some motivators seemed to be both positive and negative drivers.
  
  
  CONCLUSIONS
  Successful management of chronic illness requires recognition that the driving forces behind motivation are interconnected. In particular, the significance of family as an external source of motivation suggests a need for increased investment in the knowledge and skill building of family members who contribute to care.
authors: Australian Primary Health Care Research Institute, Acton, ACTMenzies Centre for Health Policy, Acton, ACT, Australia.
authors: Tanisha
authors: T
authors: Jowsey
authors: Carmen
authors: C
authors: Pearce-Brown
authors: Kirsty A
authors: KA
authors: Douglas
authors: Laurann
authors: L
authors: Yen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy*; D003920:Diabetes Mellitus / Q000523:psychology / Q000628:therapy; D005260:Female; D006291:Health Policy; D006333:Heart Failure / Q000523:psychology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000628:therapy; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D012959:Socioeconomic Factors