title: Self-management in palliative medicine.
abstract: OBJECTIVE
  Self-management in the palliative care domain means equipping patients and carers to manage medical aspects of illness, managing life roles and allowing adaptation to the changing dynamics brought on by illness and its progression. As well as dealing with the psychological consequences of living with a life-threatening illness in which the aim is to optimise living. This review will consider the rationale for developing and adopting self-management as a model of care.
  
  
  RESULTS
  Health policy currently advocates de-investment in traditional approaches to patient management paralleled with a re-engineering of services towards approaches required to underpin self-management care. However, the literature suggests that patients lack a fundamental knowledge and more importantly an understanding of the progression of their illness or what palliative of hospice care is. As a first step, this issue must be addressed in any self-management intervention. In terms of outcomes evidence continues to emerge that when compared with care self-management imparts sustainable understanding in targeted areas and has the potential to create a preventive spend environment.
  
  
  CONCLUSIONS
  The role of self-management in palliative care requires further elucidation yet based on the evidence which is predominately gleaned from long-term conditions it would seem sensible if not ethical to educate patients/carers to actively be involved in decision making.
authors.affiliation: Dietetics, Nutrition and Biological Sciences, Queen Margaret University Edinburgh, UK.
authors.forename: Isobel
authors.initials: I
authors.lastname: Davidson
authors.forename: Fiona
authors.initials: F
authors.lastname: Whyte
authors.forename: Rosemary
authors.initials: R
authors.lastname: Richardson
mesh_terms: D017028:Caregivers; D019468:Disease Management; D005060:Europe; D006801:Humans; D009656:North America; D010166:Palliative Care / Q000379:methods / Q000458:organization & administration; D010358:Patient Participation; D016730:Program Development; D012648:Self Care; D020377:Self Efficacy