Bringing self-management into clinical view: a qualitative study of long-term condition management in primary care consultations

Chronic Illn. 2010 Jun;6(2):136-50. doi: 10.1177/1742395309358333. Epub 2010 May 5.


Objectives: To understand social processes underpinning support for self-management of long-term conditions in primary care.

Methods: Comparative analysis of observational and interview data concerning the management of long-term conditions in UK primary-care consultations. Analysis of recordings of primary care consultations (n = 86) was conducted in conjunction with analysis of semi-structured interviews with health professionals (n = 17) and patients (n = 12) living with a long-term condition.

Results: A key finding was the infrequency with which self-management topics became legitimate objects for discussion in consultations. Analysis suggested that the maintenance of self-other relations was a prime objective for both patients and professionals, and the introduction of self-management topics threatened this process. Technology and the division of labour among primary-care professionals reinforced this tension.

Discussion: In order for self-management support to become embedded and integrated into primary care, interventions concerning long-term condition management need to take into account this tension underpinning care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude to Health*
  • Chronic Disease / therapy*
  • Communication
  • Female
  • Follow-Up Studies
  • Health Personnel
  • Humans
  • Interviews as Topic
  • Long-Term Care
  • Male
  • Middle Aged
  • Primary Health Care / methods*
  • Referral and Consultation*
  • Self Care*
  • United Kingdom