Echoing a similar theme, one theory of self-care in chronic illness emphasizes that it is crucial for patients to make evidence-based decisions and to thoroughly evaluate a variety of intervention options
In providing support for patients’ self-management, it’s important to consider the context of care and the power dynamics associated with the traditional, paternalistic, biomedical model of health care.10, 11 In other words, patients with a chronic disease are likely to develop some expertise in managing their illness, and when nurses encourage that, rather than viewing the patient as “noncompliant, questioning, or know it all,” nurses support self-management.11 However, it is important to bear in mind that numerous factors influence patients’ self-management capacity, and patients cannot be expected to manage a chronic condition entirely on their own.
SELF-MANAGING INCONTINENCE
In the self-management of urinary or fecal incontinence, a precondition for success is the proper treatment of any underlying etiologies. Patients’ self-management behaviors then operate as if in a feedback loop, with patients becoming more knowledgeable about their needs and the management strategies that work best for them.12 In the context of incontinence, six specific self-management behaviors come into play:
• identifying the problem
• seeking evidence-based knowledge
• making decisions about resource use and interventions
• developing and implementing an action plan
• self-monitoring
• setting and attaining goals
Self-efficacy supports self-management behaviors, and each behavior, in turn, promotes self-efficacy