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P - Informed Self-Management

Several key feat ures, inherent in this model, are comon to general aproaches to self-management education , and include the folowing : 1. Assessment, including the persons beliefs, knowledge, barriers and facilitators. 2. Facilitation of goal setting and problem solving. 3. Development and execution of an action plan. 4. Follow-up plan. The goal of self-management education is consistent with that of rehabilitation (i.e., to empower the individual to manage their health and daily activities toward successful community integration). However, although some rehabilitation programs have integrated a few of the approaches noted above, this philosophy has rarely been integrated systematically and comprehensively, within current rehabilitation service delivery. Most rehabilitation processes are goal directed and involve collaborative goal setting, problem solving and action planning. In contrast, the primary objective of informed self-management is to instil this set of strategies and skills, within individuals with SCI, so that they can effectively manage their own health, irrespective of the specific challenges or goals at hand. Figure 3.0 illustrates an idealized model of self-management programming within rehabilitation service delivery, depicting the current spectrum of services with typical practice patterns, and adds key self-management principles. Much of the current variation in informed self-management practice stems from the variability in adoption of these principles. Most typically, SCI rehabilitation programs have developed some structured form(s) of patient education, as well as unstructured educational delivery methods, each of which are intended to inform and equip the individual to effectively self-manage their health and daily activities, following discharge. Some programs also provide similar programming, within an outpatient or community outreach model. Figure 3.0. Spectrum of rehabilitation services associated with enabling informed self-management in persons with SCI Figure 3.0 Spectrum of rehabilitation services asociated with enabling informed self-management in INDIVIDUALS with SCI Current Practice: Facilitating Informed Self-Management in Individuals with SCI Education universal throughout rehabilitation It has been noted that education is the “essence” of SCI rehabilitation,4 borne out by results of the E-Scan. Informed self-management is potentially facilitated through structured programs of patient education, in rehabilitation settings, often delivered in group formats (see Figure 4.0) and augmented by unstructured, informal “just-in-time” education delivery. In general, most rehabilitation providers understand and appreciate their role in delivering this “just-in-time” education – although, by its very nature, there is likely to be little standardization or assurance that the information and skill development, associated with this form of educational delivery, is as effective as possible. Staff Education Problem solving = goal setting, action planning, reward, revise SUPPORTED BY RESOURCES / PRACTICE / FACILITATION How to effectively facilitate selfmanagement and adult education principles Peer Support FIGURE 4.0 Group Gardening Educational/ Needs Assessment Learning styles, priorities, risk assessment, function, barriers, facilitators, etc. Structured Education Unstructured (Just-in-Time) Education INFORMED SELF-MANAGEMENT 160 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


P - Informed Self-Management
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