title: Supporting self-management by Community Matrons through a group intervention; an action research study.
abstract: The aim of this study was to examine the feasibility and impact of a group intervention by Community Matrons to support those living with multiple long-terms conditions. Little evidence exists as to how the role of the Community Matron (CM) should be delivered to effectively enhance disease self-management and levels of self-efficacy for the service users. This qualitative participatory action research study explored the use of group work as a method of intervention by CMs. A purposive sample of 29 participants was recruited. Each patient group had 8-10 participants, led by a CM working in both the researcher and practitioner role, operating over 12-month period. Data were collected by participant observation, researcher reflexive account and interviews. Grounded theory method was used to systematically analyse the data. Three main data categories emerged: (i) comparison by patients that leads to re-motivation of the self; (ii) learning, leading to enhanced self-management techniques, through storytelling and understanding of each other's experiences; and (iii) ownership that resulted in the self-awareness, cognisance and insight into the role of the support group they were based in and how it benefited them. The core category of 'Taking back the self - understanding the whole,' conveyed the impact that this care delivery method had upon readjusting the balance of power between health professional and service users and its consequence in refreshing and improving their self-management and the patients' self-efficacy. It was concluded that CM intervention using a model of group learning can lead to more effective and efficient support, through improving self-efficacy and patients' related self-management ability.
authors.affiliation: Southern Health NHS Foundation Trust, Southampton, UK.
authors.forename: Abigail M
authors.identifier: 0000-0001-6267-6370
authors.initials: AM
authors.lastname: Barkham
authors.affiliation: Department of Health Sciences, University of York, York, UK.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Ersser
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D003150:Community Health Workers / Q000458:organization & administration*; D005260:Female; D066296:Grounded Theory; D006126:Group Processes; D006302:Health Services Research; D006801:Humans; D007858:Learning; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D020377:Self Efficacy; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom
keywords: Community Matron; action research; group learning; long-term conditions; self-efficacy; self-management; very high-intensity service users