Patients' perceived barriers to active self-management of chronic conditions

Patient Educ Couns. 2005 Jun;57(3):300-7. doi: 10.1016/j.pec.2004.08.004.


Few studies have elicited barriers to patient self-management of chronic conditions, and only one concerned people with two or more conditions. To inform development of Homing in on Health (HioH), a home delivery variant of the Chronic Disease Self-Management Program (CDSMP), we conducted 10 focus groups involving 54 chronically ill people, 46 (85%) of whom had multiple conditions. The goals were to elicit perceived barriers to active self-management and to accessing self-management support resources. Depression, weight problems, difficulty exercising, fatigue, poor physician communication, low family support, pain, and financial problems were the most frequently noted barriers to active self-management. The most common barriers to accessing self-management support resources were lack of awareness, physical symptoms, transportation problems, and cost/lack of insurance coverage. Our findings provided initial support for the Homing in on Health approach, since many of the barriers identified may be more amenable to home-based intervention than to centralized, facility-based programs.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • California
  • Chronic Disease / psychology*
  • Chronic Disease / therapy
  • Communication Barriers
  • Disease Management
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Health Services Accessibility / standards
  • Health Status
  • Home Care Services / organization & administration*
  • Humans
  • Insurance, Health
  • Male
  • Middle Aged
  • Needs Assessment / organization & administration*
  • Patient Care Planning
  • Patient Education as Topic / standards
  • Patient Participation / methods
  • Patient Participation / psychology*
  • Problem Solving
  • Qualitative Research
  • Self Care / methods
  • Self Care / psychology*
  • Self Care / standards
  • Self Efficacy
  • Surveys and Questionnaires
  • Transportation