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Self-care Support for People with Long Term Conditions, Diabetes and Heart Disease: A Whole System Approach

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Better self-management for the elderly

European self-management models to support the elderly through lifestyle and behaviour changes can benefit from enhanced mobilisation of resources and social networks. The EU has funded research to explore this potential in Europe.

Health

Estimates show that self-care initiatives have the capacity to change lifestyle and health behaviours in a way that benefits 70-80 % of people living with long-term conditions. This in turn reduces the dependence on healthcare services whilst improving public health. A one-size-fits-all self-management approach cannot work effectively across Europe due to differences in healthcare systems and welfare regimes, particularly if social networks and resources are not leveraged properly. The EU-WISE (Self-care support for people with long term conditions, diabetes and heart disease: A whole system approach) project investigated context-sensitive alternatives that could best support socially disadvantaged, marginalised or vulnerable people. It considered aspects such as the potential of harnessing available technologies (e.g. eHealth), as well as personal, community and institutional networks and resources. To achieve these aims, the project gathered data from 90 key informant interviews, 175 biographical interviews, 285 interviews with non-governmental organisations and voluntary groups, and 32 focus groups. It surveyed 1 861 diabetes patients, 150 members of community organisations per country and 1 500 network members. This revealed the impact of different healthcare systems and welfare regimes on people with long-term conditions and the level of support available. Researchers also analysed existing personal and social support networks in partner European countries, identifying key network mechanisms and developing a typology of network dynamics. Reviews of telehealth interventions and of the mechanisms implicated in making network support work for people were also integrated into the findings. A major effort focused on developing and testing a self-management support intervention, considering the strengths, weaknesses and appropriateness of existing interventions. After evaluating existing interventions, EU-WISE developed and implemented the new EU-GENIE intervention across six partner countries, proving popular among participants. EU-GENIE targets people with diabetes and heart disease, and is adaptable to different welfare and health system regimes across Europe. Overall, the project produced important data on self-management support-related macro-level influences and the role of personal networks. It also looked at the importance of voluntary organisations and community groups, as well as the role of healthcare professionals. Project findings recommend extending policy and interventions to raising awareness about the structure and organisation of personal communities, enhancing relevant relationships and maximising social engagement. EU-WISE is slated to provide policymakers a solid foundation on which to build future health policy, self-management supports and interventions.

Keywords

Elderly, self-care, healthcare, EU-WISE, diabetes, heart disease, EU-GENIE

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