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Problem solving in diabetes self-management: A model of chronic illness self-management behavior
Abstract
Management of chronic illnesses is a significant public health concern that is made more challenging by problems of regimen adherence. Effective self-management of chronic illnesses such as diabetes requires not only technical skill to perform regimen behaviors but also problem-solving skills to manage daily barriers to regimen adherence and to make appropriate adjustments to the self-care regimen. A review of the empirical literature on the relation between problem solving and disease self-management in diabetes, a chronic illness exemplar, illuminates methodological limitations that indicate a need for a theoretical framework for problem solving applied to chronic disease self-management. A problem-solving model of chronic disease self-management is proposed, derived from theories of problem solving in cognitive psychology, educational/learning theory, and social problem solving. Four essential components of problem solving in disease self-management are identified: (a). problem-solving skill, (b). problem-solving orientation, (c). disease-specific knowledge, and (d). transfer of past experience. The model is illustrated, and empirical support for this problem-solving model in the diabetes literature is discussed. The model has utility in driving testable hypotheses regarding the relation of disease-specific problem solving to chronic illness management, in developing problem-solving assessment instruments relevant to disease self-management, and in guiding disease self-management training and interventions.
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“2337/dc20-S004), patients and providers are encouraged to engage in person-centered collaborative care (3–6), which is guided by shared decision-making in treatment regimen selection, facilitation of obtaining needed medical and psychosocial resources, and shared monitoring of agreed-upon regimen and lifestyle (7).”
BackgroundEcological Approaches to Self-Management: The Case of Diabetes
Fisher, E. B., Brownson, C. A., OʼToole, M. L., Shetty, G., Anwuri, V. V., & Glasgow, R. E. (2005) · American Journal of Public Health · doi:10.2105/ajph.2005.066084 · Cited by 351
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Metadata
- Authors
- Hill-Briggs, F.
- Venue
- Annals of Behavioral Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-06
- Volume
- 25
- Issue
- 3
- Pages
- 182-193
- ISSN
- 0742-5554 (ISSN-L)
- 0883-6612
- 1532-4796
- OpenAlex
- W2044182956
- Cited by
- 241
- References
- 71
- Citations by year
- 2026: 8 · 2025: 9 · 2024: 5 · 2023: 11 · 2022: 9 · 2021: 13 · 2020: 10 · 2019: 14 · 2018: 14 · 2017: 6 · 2016: 7 · 2015: 10 · 2014: 19 · 2013: 8 · 2012: 11
- FWCI
- 1.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Behavioral Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (R01-48117-03S1)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Social Sciences › Psychology › Applied Psychology › Problem Solving Skills Development
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- diabetes self-management, problem solving, chronic disease self-management, medication adherence, problem-solving model, social problem solving, cognitive psychology, disease-specific knowledge, self-management education
- MeSH terms
- Attitude to Health, Chronic Disease, Humans, Problem Solving, Psychological Theory, Self Care, Sick Role
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