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CNA576 Self Management In Renal Nursing 4

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The aim of this assessment is to demonstrate your knowledge of the potential barriers to promoting self-management in a person with a chronic illness. The assessment requires you to reflect on and critically evaluate your development as a facilitator of learning.

1. Identify a self-management/health promoting topic targeting clients, health care colleagues or a community group. Review the literature surrounding your chosen topic and develop a session plan identifying key learning objectives.

2. Prepare a 10-20-minute teaching/learning episode. When developing the session consider the evaluation process you will undertake.

3. Present the session to your target audience and seek feedback from the session.




Every healthcare professional have the duty to encourage self-management to every patients suffering from chronic disorders. Self-management in the present generations should go beyond the traditional knowledge-based patient education for including processes that help in developing the patient problem solving skills as well as to improve self-efficacy. It should also help in supporting of aplication of knowledge in the real life situation that are important for the patients (Holden, Schubert and Mickelson 2015). Therefore, the patients should be educated not only about the different ways by which self-management should be carried on but they should be also taught about the importance of self-management for handling chronic ailment symptoms. The presentation provided to the patient for teaching them about the ways of taking self-care for chronic kidney diseases and open discussions that was carried on after the presentation helped me in understanding some of the potential barriers that patients face in self-management. This assignment would mainly be discussing on such potential barriers so that professionals become aware of such barriers and accordingly take necessary interventions.

Physical barriers:

One of the barriers that were noticed among some of the patients suffering from chronic kidney disorder is the physical barrier. They are seen to suffer from physical disability mainly due to reduction in strength as well as sensation. Researchers have noted that patients with chronic kidney ailments suffer from sleep problems, fatigue and weakness as well as decreased mental sharpness (Chiauzzi, Rodarte and DasMahapatra, 2015). They suffer from swelling in the feet and the ankles as well as from muscle twitches and cramps. All these make them tired and suffer so much that they do not feel like taking initiatives for self-management. They suffer from poor quality lives and unless the professionals help the patients in tackling the symptoms with effective interventions and pharmacologic treatments, it becomes difficult for them to develop the enthusiasm to overcome the tiredness and undertake activities of self-management.

Psychological barriers:

Physiological barriers were also noticed when interacting with the patients regarding their feelings about self-management. Major depression as well as emotional were the two most psychological challenges that affect self-care management of the patients suffering from chronic ailments. Researchers are of the opinion that while high level of distress as well as frustration mainly act as impetus for someone to seek help, it also becomes the barrier for achieving behavioral goals. Many of the patients state that they become frustrated from drinking water by measuring the amount every time and it especially affects them when they are very thirsty but cannot drink much water (Ehde et al. 2014). Their restricted lifestyles make them depressed, as they cannot lead regular lifestyle like their fellow friends and others. Researchers are also of the opinion that low elf-efficacy is another major psychological barrier for optimal self-care and management.


Cognitive barriers

Cognitive barriers are one of the most important barriers that impeded the self-care and management strategies. Many researchers are of the opinion that the knowledge of the patient about the specific chronic condition has a powerful influence on his or her ability of performing optimal self-care. For example, it is seen that people with such chronic conditions might not understand why the disorder took place, the working of the different medications that were allocated for the patients, unable to understand the different signs and symptoms of worsening condition and many others. Lack of knowledge about the disorder and understanding of the diet plan were other barriers (Miller, Cafazzo and Seto 2016). Patients do not understand the importance of the self-care management and the negative outcomes it might affect on their health. Therefore, they do not feel the need of undertaking self-care management.

Health literacy

Health literacy is another barrier that might also impeded self-care and management of the persons suffering from chronic kidney problems. This mainly helps in including the ability of patients in making decisions. These allow the patient in applying new information for navigating the healthcare system successfully. Researchers are of the opinion that low health literacy is one of the most important barriers in active participation of care by the patients and hence professionals should pay importance in helping the patient to overcome this barrier (Kim et al. 2016). Studies have suggested that people with low literacy levels have more difficulty in learning of the different self-care skills. It has been also noticed there might be many patients with language issues, poor memory as well as dementia. This would also prevent the patients from learning as well as utilizing the newer set of skills (Aucker et al. 2015). Therefore, professionals should be taking the responsibility of simplifying the care and tailoring the education to the individual patients according to the individual abilities of the patient.

Socio-economic position

Anther barrier that I have recognized is the economic barriers. Socio-economic position is seen to be a significant factor in the determination of health status. While discussing with the patients, after the presentation, many of patients coming from poorer socio-economic background are of the opinion that resources required for supporting proper self-care as well as access to continuing care can be very expensive. Many of the patients also stated that they were also concerned about the adequacy of the health insurance for the different ongoing treatment as well as monitoring (Aldridge et al. 2016). All this were stated by them to be the major challenge for those required help with their chronic care of the kidney diseases.

Social and cultural barriers:

One of the interesting facts that I also observed was that social and cultural barriers also acted as challenges for self-management of the patients. Through a detailed interaction with the patients, I have seen that the involvement of the family members can either support or hinder the self-care behaviors of the patients. Women were seen to be more integrated in the extended family networks. They are mainly seen to live with people of other generations while men are seen to rely mainly on their partners for their support (Kruse et al. 2015). Again, there remains specific role for spirituality as well as participation in the community religion as well as cultural practices like traditional healing. These different preconceived notions may also impede the self-management attitude of each of the patients and can alter their behaviors accordingly.

From the advice discussion, it becomes clear that important aspects are present which might affect the self-care management of the patients. These are physical barriers, psychological barriers, health literacy behaviors, cognitive behaviors, economic behaviors as well as social and cultural behaviors. The professionals should therefore realize them and accordingly take interventions helping them to overcome challenges and undertake self-care effectively.



Aldridge, M.D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., Centeno, C. and Meier, D.E., 2016. Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliative Medicine, 30(3), pp.224-239.

Ancker, J.S., Witteman, H.O., Hafeez, B., Provencher, T., Van de Graaf, M. and Wei, E., 2015. “You get reminded you’re a sick person”: Personal data tracking and patients with multiple chronic conditions. Journal of medical Internet research, 17(8).

Chiauzzi, E., Rodarte, C. and DasMahapatra, P., 2015. Patient-centered activity monitoring in the self-management of chronic health conditions. BMC medicine, 13(1), p.77.

Ehde, D.M., Dillworth, T.M. and Turner, J.A., 2014. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. American Psychologist, 69(2), p.153.

Holden, R.J., Schubert, C.C. and Mickelson, R.S., 2015. The patient work system: An analysis of self-care performance barriers among elderly heart failure patients and their informal caregivers. Applied ergonomics, 47, pp.133-150.

Kim, K., Choi, J.S., Choi, E., Nieman, C.L., Joo, J.H., Lin, F.R., Gitlin, L.N. and Han, H.R., 2016. Effects of community-based health worker interventions to improve chronic disease management and care among vulnerable populations: a systematic review. American journal of public health, 106(4), pp.e3-e28.

Kruse, C.S., Argueta, D.A., Lopez, L. and Nair, A., 2015. Patient and provider attitudes toward the use of patient portals for the management of chronic disease: a systematic review. Journal of medical Internet research, 17(2).

Miller, A.S., Cafazzo, J.A. and Seto, E., 2016. A game plan: gamification design principles in mHealth applications for chronic disease management. Health informatics journal, 22(2), pp.184-193.


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