Managing Long-term Conditions and Chronic Illness in Primary Care: A Guide to Good Practice

by Carrier; Judith

• ISBN13: 9780415450881
• ISBN10: 0415450888
• Edition: 1st
• Format: Nonspecific Binding
• Copyright: 2009-04-06
• Publisher: Routledge

Summary

Effective management of long-term conditions is an important aspect of contemporary nursing policy and practice. Systematic and evidence-based care which takes account of the expert patient and reduces unnecessary hospital admissions is vital to support those with long-term conditions/chronic diseases and those who care for them. This book draws together the key issues in managing long-term conditions and provides a practical and accessible guide for nurses and allied health professionals in the primary care environment. It covers background context and policy in the UK and further afield, as well as practical guidance for all key aspects of long-term condition management, including: the physical and psychosocial impact of long-term conditions effective case management self-management and the expert patient behavioural change strategies and motivational counselling nutritional and medication management. Packed with helpful, clearly written information, Managing Long-term Conditions and Chronic Illness in Primary Careincludes two chapters of case studies as well as key fact boxes and pointers for practice throughout. It is suitable for pre-registration students undertaking community placements and post-registration students studying long-term condition/chronic disease management.

Author Biography

Judith Carrier is Lecturer and Professional Head of Primary Care/Public Health Nursing at Cardiff University, UK where she is responsible for practice nurse education. She has a regular column in Practice Nursing.

Table of Contents

List of Illustrations	p. xiii
List of contributors	p. xv
Acknowledgements	p. xvii
Social and political background	p. 1
Introduction	p. 1
Incidence and prevalence	p. 3
Current policy drivers	p. 6
International models of support for management of LTCs	p. 12
Broad Theoretical Frameworks	p. 13
Service Delivery Models	p. 15
Key points	p. 18
Further areas to consider	p. 18
Physical, psychological and psychosocial impact of Living with a long-term condition and social influences on health	p. 19
Introduction	p. 19
Physical impact	p. 20
Psychological/psychosocial impact	p. 30
Social influences on health	p. 33
Meryl Prosser	p. 38
Key Points	p. 38
Further areas to consider	p. 38
Case management and disease-specific care management	p. 39
Introduction	p. 39
Case Management (including community matron role)	p. 40
Disease-specific care management	p. 45
Role of the district nurse in the management of people with LTCs Gina Newbury	p. 46
Role of the practice nurse in the management of people with LTCs	p. 48
Role of the multi-disciplinary team in the management of people with LTCs	p. 50
Conclusion	p. 52
Key points	p. 52
Further areas to consider	p. 53
Importance of self-management	p. 55
Introduction and definition	p. 56
Is self-management effective? Evidence supporting self-management interventions	p. 57
Strategies for successful self-management	p. 61
Who's suitable for self-care?	p. 63
Developing concordance/empowerment/shared decision-making/patient-centred care	p. 63
Self-management programmes	p. 64
Organisations that advise on self-management	p. 67
Key points	p. 69
Further areas to consider	p. 69
Motivational interviewing	p. 71
Understanding the process of behaviour change	p. 73
Style Council	p. 76
Motivational interviewing	p. 77
MI spirit	p. 78
MI principles	p. 79
Using MI in practice	p. 80
MI Skills	p. 81
MI strategies	p. 83
What is the evidence for MI?	p. 87
Developing MI skills	p. 88
Key points	p. 88
Further areas to consider	p. 89
How to identify a person with a long-term condition	p. 91
Introduction	p. 91
Diabetes mellitus	p. 92
Cardiovascular disease	p. 96
Chronic kidney disease	p. 99
Epilepsy	p. 100
Respiratory conditions	p. 101
Musculoskeletal conditions	p. 104
Key Points	p. 107
Further areas to consider	p. 107
Effective management of people with a long-term condition	p. 109
Introduction	p. 109
Protocols	p. 110
The three Rs: registration/recall/review	p. 112
Teamwork and referral criteria	p. 119
Audit	p. 120
Conclusion	p. 122
Key points	p. 122
Further areas to consider	p. 123
Evidence-based practice	p. 125
Introduction	p. 125
Definitions and brief history of evidence-based practice	p. 126
Applying evidence to practice	p. 127
Finding reliable secondary (evaluated) sources	p. 132
Accessing systematic reviews, meta-analysis and narrative synthesis	p. 132
Clinical guidelines	p. 134
Other guideline-related resources	p. 135
Conclusion	p. 139
Key points	p. 140
Further areas to consider	p. 140
Case scenarios	p. 141
Introduction	p. 141
case scenarios	p. 142
complex case scenarios	p. 157
Conclusion	p. 161
Key points	p. 161
Further areas to consider	p. 161
Nutritional and medication management	p. 163
Introduction	p. 163
nutritional management of patients with LTCs	p. 164
Key resources	p. 169
Key points	p. 169
Further areas to consider	p. 169
medication management	p. 169
Conclusion	p. 177
Key points	p. 178
Further areas to consider	p. 178
Conclusion	p. 179
References	p. 181
Index	p. 191
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