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Delineating the concept of self-management in chronic conditions: a concept analysis
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  • Published on:
    Response to the comment on BMJOpen about Delineating the concept of self-management in chronic conditions: a concept analysis
    • Dominique Van de Velde, Occupational Therapist Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Occupational Therapy Program, Ghent University.
    • Other Contributors:
      • Freya De Zutter, Occupational Therapist
      • Ton Satink, Occupational therapist
      • Ursula Costa, Occupational Therapist
      • Sara Janquart, Occupational Therapist
      • Daniela Senn, Occupational Therapist
      • Patricia De Vriendt, Occupational therapist

    Dear Editor,

    In 2019 we were fortunate to publish a ‘concept analysis in self-management’ in BMJ Open (Van de Velde, 2019). Later on we received a reply from Riegel and colleagues. We wish to thank these authors of the International Centre for Self-Care Research for writing this appealing comment on our article. This is a nice way of exchanging knowledge and insight in the concept of self-management and therefore we appreciate this greatly.

    We like to respond to this reply in a extensive way since we think that this could be of great value for all researchers as example how scientific communication (as supported by BMJOpen) might strengthen health care and health care research.

    Our intention was indeed to clarify the concept of self-management since this concept presently has been put forward as an important key-factor in new ways of defining health, e.g.: “the ability to adapt and self-manage in the face of social, physical, and emotional challenges” (Huber, 2014). Before this definition can be considered viable, the key concept should be clarified and untangled leading to a general consensus on the concept. Consequently, this concept analysis has been performed because of the demographic and epidemiological transition which is accompanied by new attitudes towards health and health care delivery in which self-management became a pivotal concept. Coming from this understanding, our main intention was not to clarify differences between juxtaposing con...

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    Conflict of Interest:
    We are all members of the 'non-funded' Joint International Program (JIP) on Health Promotion and Self Management.
  • Published on:
    Self-management and self-care, two sides of the same coin
    • Barbara Riegel, Professor and Co-Director, International Center for Self-Care Research University of Pennsylvania
    • Other Contributors:
      • Tiny Jaarsma, Professor and Co-Director, International Center for Self-Care Research
      • Anna Stromberg, Professor and Associate Director, International Center for Self-Care Research
      • Ercole Vellone, Associate Professor and Associate Director of the International Center for Self-Care Research

    We read with interest the paper by Van de Velde et al delineating the concept of self-management in chronic conditions.1 We agree that there is a lack of consensus on the meaning of self-management, ambiguity regarding the concept, and an urgent need for uniformity with regard to terminology. One major area of ambiguity is the relationship between self-management and self-care. These terms are often thought of as synonyms, used interchangeably, or considered as integrated concepts (e.g. self-care as an overarching or umbrella term, with self-management as onecomponent of self-care).2 This is why, until 2018, major search engines combined the terms. When one searched for “self-management”, literature on “self-care” was provided as well. Since Van de Velde and co-workers aimed to delineate the concept of self-management and develop a definition for its use in healthcare, we expected a more thorough review of related concepts in their concept analysis. Thus, we were surprised to find that several important publications on self-care were excluded.

    We believe that the concept analysis by van de Velde et al would have been stronger if they also had included publications related to self-care. In 2012, after many years studying self-care in heart failure, we developed the Middle-Range Theory of Self-Care of Chronic Illness,3 which was updated this year.4 In this theory we defined self-care as the process of “maintaining health through health promoting practices and managi...

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    Conflict of Interest:
    We are the Directors and Associate Directors of the International Center for Self-Care Research