Building Bridges between healthcare professionals, patients and families: A coproduced and integrated approach to self-management support in stroke.
BACKGROUND
Programmes providing self-management support for patients and families are gaining attention and have shown promising outcomes with regards to reducing long-term unmet needs post stroke. However, notions of what good self-management support looks like can differ depending on professional opinion, individual preferences, skills and experiences of patients and their families as well as on how care and rehabilitation is organised in a particular healthcare setting. This resonates with the perspective of patient-centred care, according to which the meaning of good care is not universal, but rather jointly shaped between healthcare professionals and patients in everyday interactions. While self-management support is continuously co-produced in care and rehabilitation practices, most self-management programmes are typically provided as an 'add-on' to existing statutory care.


OBJECTIVE
This paper aims to deepen the understanding of how self-management support can be made an integral part of everyday care and rehabilitation using Bridges methodology.


METHODS
The authors provide a self-reflective account on 'Bridges' an integrated approach to self-management support, which is used by healthcare professionals within acute and community stroke rehabilitation across the UK, and in some parts of New Zealand and Australia.


RESULTS
Bridges is based on self-efficacy principles, but has a central aim of professionals sharing decision-making and expertise with patients and families in every healthcare interaction. Methodologically, the co-production of a Bridges support package with local healthcare professionals and patients is critical. The authors present the values articulated by the support package and how it engages professionals, patients and Bridges training facilitators in a continuous process of adjusting and re-adjusting situated self-management support practices.


CONCLUSIONS
Our reflections reveal the need to consider development and implementation of self-management support as one and the same on-going process, if we are to facilitate successful engagement and interest from healthcare professionals as well as their patients and families.
Faculty of Health Social Care and Education, St Georges University of London and Kingston University, London, UK.
Fiona
F
Jones
Faculty of Health Social Care and Education, St Georges University of London and Kingston University/Bridges Self-Management, London, UK.
Heide
H
Pöstges
Faculty of Health Social Care and Education, St Georges University of London and Kingston University/Bridges Self-Management, London, UK.
Lucinda
L
Brimicombe
D001294:Attitude to Health; D001315:Australia / Q000453:epidemiology; D003657:Decision Making; D019468:Disease Management; D005190:Family; D006282:Health Personnel / Q000523:psychology / Q000639:trends; D006801:Humans; D010358:Patient Participation / Q000379:methods / Q000639:trends*; D011369:Professional-Patient Relations; D012648:Self Care / Q000379:methods / Q000639:trends*; D020377:Self Efficacy; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology; D000071939:Stroke Rehabilitation / Q000379:methods / Q000639:trends*
Self-management; co-production; long-term conditions; stroke