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Helen Francis

Doctor of Philosophy, (Health )
Ƶ Completed: 2017
College of Health

Citation

Thesis Title
How do people with multiple long-term health conditions experience the self-management approach to health care?

Read article at Massey Research Online:

Many people now live with several long-term conditions (LTCs). Many such people are also socio-economically disadvantaged and contend with chaotic lives alongside their Illnesses. In a multiple case study, Ms Francis followed 16 people with significant LTCs over approximately 18 months, alongside their primary care clinicians. Patient stories revealed complex, entangled lives marked by loss, poverty and daily challenges. She found patients were exhausted and their needs were especially ill-matched with the self-management approach to care currently endorsed and funded at policy and practice level. Clinicians needed to manoeuvre outside the model of service to compassionately and pragmatically support the patients as best they could. Her findings surfaced examples of care valued by both patients and clinicians that occurred outside the currently endorsed self-management approach. Building on these, an approach to care was described that is supportive, anticipatory and released from the confines of the current biomedically limited self-management approach.

Supervisors
Professor Jenny Carryer
Dr Jill Wilkinson