Chapter 14
Tools to help you plan and
support self care

 

Tool 21

Self care aware consultation style: encouraging, guiding and providing support to patients to adopt self care

Why you should use this

Practise supporting patients to adopt self care as an integral part of their consultations, if you do not do so already, using this tool to reflect on how and when you can include self care support in your everyday practice.

When to use this

When you are upskilling your approach to supporting self care – initially or to review your progress.

What to do

Read through the sequence of boxes that follow on pp. 232–3, to realise what good practice you are aiming at in your self care aware consultations. You could complete Table T21.1 as part of a training session during role play, where you are the health professional whom a fictitious patient is consulting. Then others observing the role play or playing the part of patient can comment on your behaviour. Alternatively you could audiotape or video maybe three consultations after which you review the extent to which you adopted any or all of the eight types of behaviour described below in the table. Then make conclusions, resolve to improve your practice, and review at a later date.

Examples of fictitious scenarios are: ‘The fictitious patient has had a bad back for the past 10 days’, or ‘The fictitious patient consults the GP to ask for tablets to help her to lose weight’.

How it works (insight)

It gives you the opportunity to reflect on the extent to which you are using the consultation to encourage and support self care, in an optimal way that is challenging and motivating for the patient.

Whom to engage

Any health professional who wants to improve their skills in supporting self care to individual patients.

 

 

How much time you should allow

Allow 45 minutes for discussion of a role play of one consultation lasting 10–15 minutes. Allow 1.5 to 2 hours to review and reflect on a series of say three audio- or videotaped consultations.

What a facilitator should do

Set up the exercise so that those involved feel comfortable, use constructive feedback, give the observers and then those in role play a chance to feed back on what has gone well and what might be improved. Sum up and make conclusions about necessary changes to practice and behaviour.

What to do next

Repeat the exercise and review a series of consultations, say three months later, to check out how things are going and if patients are more likely to adopt self care. Follow up specific patients to monitor their progress – e.g. they make less frequent consultations with the GP or practice nurse about trivial symptoms or minor ailments.

What makes it work better

Welcome the objective feedback of others. Involve a colleague in critiquing your consultations so that you can compare your review of the types of behaviour you’re using with their assessment of you.

What can go wrong

Your initial enthusiasm might founder under the pressure of other commitments without protected study and reflection time.

 

Recommended sequence for a self care aware consultation exercise

1 What is a ‘self care aware consultation’? It involves: all contacts with the wide primary care team members using the person’s own potential for independent action building a set of skills and attitudes for future use providing support where necessary.

 

2 What is a ‘self care aware consultation’? The outcome is: a coherence across the primary care team patients and carers building on their existing skills more patient-centred consultations in general practice.

 

3 The keys to a ‘self care aware consultation’ Understanding the patient’s self care journey. Supporting the patient’s self care decisions.

 

4 Types of ‘self care aware consultations’ One example: self care for self-limiting illness. Other examples: long term conditions, support for carers, lifestyle choices, risk awareness.

 

5 Understanding the patient’s self care journey Taking a history that includes self care – for how long have the symptom/s been present? – what has the patient already tried? Hot water bottle, resting, taking OTC medicines, complementary products or food supplements, seeing an allied health professional or alternative practitioner? – and for how long?

 

6 Understanding the patient’s self care journey What have you already tried? How long have you tried this? What were you trying to achieve by doing/taking this? Has it worked and how? Have you stopped doing what you tried – and why? What could you do next time?

 

7 Understanding the patient’s self care journey Answers will reveal: how willing the patient is to think about their health options the potential for change now and in the future the patient’s reasons for consulting the possibility of coming back to advise on self care at the end of the consultation.

 

8 Supporting the patient’s self care decisions Endorse current self care practice and encourage it for the future. Ensure understanding of the right time period for self care before the need for professional help is to be sought. Endorse consultation with other professionals in the primary care team. Use written information where possible to support advice and enforcement of self care.

 

9 Aide me´moire What have you already tried? How long have you tried this? What were you trying to achieve by doing/taking this? Has it worked and how? Have you stopped doing what you tried – and why? What could you do next time?

 

Chapter 14 index

 

This document is intended as a guide only.
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