ArticleInternational journal of nursing studies advances2026
A nursing process for self-management support in home healthcare: A qualitative study.
Article in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Nurses play a key role in providing self-management support to people living with long-term health conditions. Home healthcare patients often face difficulties self-managing because of disabilities and multi-morbidities. In addition, providing healthcare in patients' homes comes with specific challenges since the healthcare providers have less control over the care environment. Therefore, home healthcare is an ideal setting for investigating how nurses provide self-management support in complicated situations. Aim: This study focuses on the process and activities nurses undertake when providing self-management support to home healthcare patients, developing a model to elaborate and clarify nurses' self-management support work. Methods: In this interpretive description study, 24 registered nurses, working with home healthcare services, took part in qualitative semi-structured interviews. Interviews were performed in two rounds (in 2019 and 2024). During the second round the nurses commented on and helped further develop the model illustrating the findings. Results: This study presents a Nursing Model of Self-management Support Provision. Part one, shows how nurses' working conditions and individual belief systems impact their ability and willingness to provide self-management support. Part two, describes the nurses' clinical judgement and strategies used to provide self-management support. In summary, nurses described how their employing organization created barriers to self-management support, due to lack of guidelines, limited time and training. Differing belief systems also influence practices, nurses being deliberate in providing self-management support used a wider range of supports and could adapt them to the patients' situation. Nurses assessed patients' risks and potential for self-management before deciding whether to provide self-management support. Most nurses described using a relatively limited number of supports. Common support included teaching and giving advice, supporting sustainable behaviour change, and support to manage other resources. Finally, the nurses evaluated patients' self-management performance to decide whether patients should continue to self-manage, needed more support, or return to assisted healthcare. Conclusions: The developed model can be used to clarify nurses' self-management support activities, for example in teaching or in planning self-management support initiatives. Consistent with previous research, the nurses identified information as the most used self-management support strategy. To provide sufficient self-management support nurses' need 1) a working environment that facilitates self-management support, 2) adopt a wide range of self-management support strategies, and 3) move beyond a traditional medical understanding of self-management.
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