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CNA576 Self Management In Renal Nursing For Chronic Illness Patients

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This assignment will help you build on assignment 1 in which you identified barriers to self-management promotion. In this assignment you will work in online groups to identify, discuss and critique strategies to overcome these barriers.
Part A: Online Discussion
Generate at least one new discussion thread on the day the discussion opens (10th September) and participate in at least two other discussion threads within your group (over the full length of time the group is open) on the topic of self-management promotion, principles and barriers (write a total of at least six posts x 250 words each). Please note, a single posting in a thread is insufficient to count as a discussion. There must be at least two-way inquiry and examination of ideas. You may use critical evaluation of your own presentation given for assessment one to illustrate points briefly. However, the main purpose is to discuss the topic with support from the academic literature. All postings for marking are to be academically written and referenced.
Part B: Summary
Following the discussion, you must submit an academic paper that  shows evidence of knowledge and understanding of the principles and strategies to overcome at least 3 barriers to self-management promotion. The summary may incorporate critical reflection of the ideas discussed as a form of reflection on your own learning outcomes. With your paper you should include the discussion postings you made as appendices, this will provide evidence of your active participation within group discussions.



Chronic illnesses have risen in number with fears of increasing risks for further increase in such ilnesses. This is due to environmental risks such as air pollution, smoking, lack of physical activities and unhealthy diets (Celler, & New South Wales University Sydney, 2017). Self-care among patients with chronic diseases is an important aspect of health managements. In the recent years, chronic management programs have shifted to the patients. This is due to the vast research evidence that has shown that programs involving social support, self-efficacy, follow up plans and improvement of coping skills have a very significant and positive effect towards management A proper self-management model aims at enhancing patients knowledge, skills and capacity to manage their health and wellness.  Additionally, self-management programs have increased survival tactics for patients. Many patients can now live for longer periods with managed complex illnesses (Pulvirenti, Mcmillan, Lawn 2014). There are thus several strategies and principles that guide an effective self-management program helping one to overcome the many barriers to effective promotion. This paper explores the many strategies and principles that help overcome barriers to an effective self-management promotion.

To begin with, lack of information concerning the basic aspects of the diseases is a great barrier to effective self-management promotion (Coulter, 2016). Education is one of the most important aspects of an effective self-management promotion.  As a strategy and a principle, education forms the basic step in promoting self-management. Education is offered as a supplement to the professional care provided by the healthcare facilities (Swan, & Rural Health Education Foundation. 2014). Originally, client education made much focus on issues of technical self-administration such as insulin administration. Efforts are currently made to expand these abilities for a much more complex self-diagnosis (Celler, & New South Wales University Sydney, 2017). Client education needs to incorporate teachings on how the client can properly understand the problems in their bodies that relate to chronic illness and how to manage them. Initially, patients would only administer the insulin as per the prescription. Recent developments educate clients on how to carry out self-diagnosis and solve problems within themselves. Programs are developing to teach patients much more technical activities such as how to respond to body problems relating to chronic illness. They learn to exercise more control of their disease treatment. Additionally, behavioral education is a key aspect of self-management. Clients need to be effectively taught on behavioral risks. This education will teach clients on how to respond to physical changes and solve problems relating to the illness.

Most importantly, culture forms a very crucial barrier to self-management promotion. Culture basically refers to the social context that a patient associates (National Chronic Condition Self-Management Conference, & Australia 2015). Traditional perceptions and practices need to be incorporated into programs to cut through to the aged. Australia has a vast culture which needs to be nurtured to spread acceptance of these programs. Researchers have found out that some patients comply with such programs only to please the clinicians as a moral obligation (Swan, & Rural Health Education Foundation. 2014). This is a value that has very weak foundations and is bound to end without proper follow ups. It is important for the programs to create a culture of self-responsibility and the desire to be better among the clients. Clients need to feel the need to create a culture of self-responsibility and self-care. This will properly promote self-managements programs (Celler, & New South Wales University Sydney, 2017).

Other principles such as creating a sense of local bonding and communism with the clients, developing mechanism to eliminate structural barriers and facilitate empowerment programs as well as fostering leadership and advocacy development form some of the best strategies to eliminate the barriers to self-management programs (Chang, & Johnson, 2017). Structural barriers involve accessibility to healthcare and such programs. Self-management efforts must incorporate the elimination of such barriers by creating easy accessibility to healthcare. This is through creating a community between the healthcare providers and the locals. Communism also builds trust easing education and empowerment on programs of self-management. By fostering leadership and self-participation, the odds for success are highly minimized. People will seek more knowledge and skills unlke in a demoralized community (National Chronic Condition Self-Management Conference, & Australia 2015).


Importantly to note, empowerment interventions involve a critical examination of the constraint factors in the community involved (Coulter, 2016). Chronic illnesses are common among the aged. In modern world, technology and education is well known to people of middle age and the youths. Educating the elders on self-management programs and iontervention thus takes much more effort than educating youths and the middle age. To this effect, Australia has a relatively long lifespan which thus requires strong support from the younger generation (Swan, & Rural Health Education Foundation. 2014).

Moreover, intervention programs must incorporate the conditions of the local (Chang, & Johnson, 2017). There is a great correlation between the strategies used and the barriers. The nature of the barriers determine the strategies to counter and provide an effective outcome. However, the greatest solution to many barriers is education and creating a sense of leadership and self-authenticity.  Creating the will to participate in a self management program is an important aspect of a successful intervention program (Coulter, 2016). A successful self-management program must therefore draw the relationship between the barriers and the strategies in place.

Australia, just like every other country in the globe is faced with environmental risks such as air pollution and unhealthy diets especially among low income families (National Chronic Condition Self-Management Conference, & Australia 2015).  A proper self-management program need therefore to incorporate education and efforts towards environmental protection and proper life behaviors. Smoking is a major risk to prevalence of chronic illnesses. One of the most important strategies in developing self-efficacy is through creating an environment that complements the efforts made.  The relevant stakeholders must thus carry out proper education on environment and effective health protection activities (Registered Nurses Association of Ontario, 2010).

A case study in the Australian context determined several limitation. One of the most notable observation was that in obtaining care, there are many areas of fragmentation (Pulvirenti, Mcmillan, and Lawn 2014). For example, a type II diabetes patient, low socio-economic status and ischemic disease of the heart have the nurse in practice and the general practitioner located in one place. The diabetes educator, ophthalmologist, dietician and the podiatric are all located in different health facilities. Pharmacy and pathology services are also separate (Celler, & New South Wales University Sydney, 2017). This make streaming support for self-management programs very difficult as the relevant sectors are not properly coordinated. In this sense, it is necessary that the necessary bodies for an effective management of chronic diseases are coordinated. This eases patient’s efforts for self-management and follow up efforts (Chang, & Johnson, 2017).

In conclusion, there are many barriers to an effective self-management program. However, every barrier has a counter strategy that if properly managed would eliminate the barrier. Culture, high health illiteracy levels, structural barriers, lack of authentic self-will and predominance of the aged are some of the important limitations to an effective sel-managemnt program. However, with strong principles and strategies such as incorporation of cultural values, strong education programs, increasing accessibility of healthcare programs and empowering every intervention aimed at supporting self-management among chronic illness patients are effectively changing the circumstances. These process surpass traditional mechanisms for chronic illness control through enhancing problem solving skills, promote applications of real life knowledge in life and promote self-efficacy. Several theories have been identified that can aid in effective self-management programs. There is still room for further developments as programs aim at becoming community centered and focused on the specific needs of the locals. There must be investment t in research to effectively understand the needs of the community and the best ways to promote self-management.


Reference List

Celler, B., & New South Wales University Sydney. (2017). Home telecare for chronic disease management. United States: New South Wales University School of Biomedical Engineering.

Coulter, A. (2016). Engaging patients in healthcare. Berkshire, England: Open University Press.

Chang, E., & Johnson, A. (2017). Chronic Illness and Disability: Principles for Nursing Practice. Philadelphia: Elsevier.

National Chronic Condition Self-Management Conference, & Australia (2015). Guiding us forward: National Chronic Condition Self-Management Conference: conference proceedings. Canberra: Dept. of Health and Ageing.

Pulvirenti M, Mcmillan, J, Lawn S. (June, 17,2014). Empowerment, patient centered care and self-management. Health expectations: An international journal of public participation in healthcare and health policy. Retrieved from

Registered Nurses Association of Ontario, (2010). Strategies to support self-management in chronic conditions: Collaboration with clients. Ontario: RNAO

Swan, N., & Rural Health Education Foundation. (2014). Multidisciplinary management of chronic diseases. Deakin, ACT: Rural Health Education Foundation


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