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Self-management of long-term conditions: a district nursing perspective of patient engagement

02 October 2024
Volume 29 · Issue 10

Abstract

The UK has a growing ageing population with increased prevalence of long-term conditions. It has the potential to overwhelm the country's healthcare system. The COVID-19 pandemic and its risk of transmission provided an opportunity for people with long-term conditions to focus on self-care and for district nurses to promote self-management. Self-management strategies, such as digital technology, motivational interviewing, social prescribing and shared decision-making can assist them in planning a whole-population approach towards managing physical and mental wellbeing. For this to become a reality, investment is needed to educate the patients, their carers, district nurses, multidisciplinary teams and to ensure the sustainability of self-care methods for future practice.

The UK's population has been increasing steadily and was estimated to be 67 million in 2021 (Statista, 2023). In the past 10 years, the number of individuals aged 65 years and over has increased from 9.2 to 11 million and is predicted to rise further (Office for National Statistics, 2021; 2023). Ageing, alongside lower socio-economic status, increases the prevalence of long-term condition. An estimated 1 in 3 people live with a long-term condition and this situation threatens to overwhelm the current healthcare system (Manderson and Wahlberg, 2020; Public Health England, 2020; Statista, 2023).

The NHS Long Term Plan (2019) is committed to developing and investing in community services and highlighting the importance of healthcare professionals' role in promoting patient self-care and management. The requirement for highly qualified district nursing staff to meet this commitment is further emphasised in the NHS Long Term Workforce Plan (NHS, 2023a), to meet the increasing complexity of the population's needs. The staffing crisis, alongside unsafe and unsustainable demands on services, requires a focus on alternative strategies to promote self-management of long-term conditions and to avoid overwhelming the system (Queen's Nursing Institute (QNI), 2019; 2023, Devine, 2021; NHS, 2023a). This article explores the promotion and empowerment of self-care and self-management strategies for individuals with long-term conditions from a district nursing perspective.

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