Living with chronic conditions
Living a healthy life with chronic conditions: Primary health care programme
by Diane Henare
I am involved with the “Chronic Disease Self Management Programme” (CDSMP) out of Stanford University. The programme uses the book “Living a Healthy Life with Chronic Conditions", and is a very structured approach. This programme has been around for some years and was being actively promoted by the Arthritis Foundation. It is also actively promoted in South Auckland where it has been running for over four years.
The programme has strong links with an occupational therapy approach as it is based on self management, self efficacy, problem solving, and action planning. The programme is aimed at community delivery by people with chronic conditions rather than just by health professionals (we qualified on both counts as we are health professionals, and both have a chronic condition). Participants receive support from each other in the group, and see that they are not alone with their conditions - that there are others out there who are managing. Accordingly, feedback from our three groups show an increased confidence to self manage.
In one group two women who had never met decided (on day one!) to team up for a walk three days a week. One of those women has subsequently gone on to pick up a course she had lost motivation for because of her pain. In another group, a young woman with chronic pain was not getting up before 10am most days, and set herself a target to be up before 10am, follow a walking and eating programme, and get involved in the community. She achieved this, and has gained significantly in self esteem. Another participant stated at the end of the course that she now accepted her terminal condition and was no longer denying what she needed to do to manage it.
The programme in Northland is called Whakamana Hauora, (promoting wellbeing). Content of the programme includes understanding the differences between acute and chronic conditions; identifying common problems; using your mind to manage symptoms; action planning (every session); dealing with difficult emotions; the nature of physical activity; tools for problem solving, breathing, relaxation, pain and fatigue management; education on healthy eating; making future plans; dealing with health care providers and systems; managing depression; positive thinking; and guided imagery. All of these are bread and butter to occupational therapists.