Identifying barriers is the fi rst step in collaborating with a
patient with a chronic condition to improve self- management
strategies. Barriers to self-care are a patient’s own perception
of how challenging are the social, personal, environmental,
and economic obstacles to achieving or maintaining
a specific behavior or a set goal for that behavior. These
barriers have many dimensions, including those related to
healthcare providers, healthcare systems, and sociocultural
issues. Providers may lack time or appropriate skills, or may
incorrectly label a patient’s behavior as “non-adherent” or
“non-compliant”. Providers should also consider how social
and health system factors contribute to these barriers. Access
to healthcare services and resources, especially primary
care, can also be a signifi cant barrier to optimal self-care.
Another issue is that not all providers work in settings that
include an integrated approach to chronic care and support
or advocacy for self-management.