It is becoming increasingly important that people take care of themselves as best and as long as possible. Self-management abilities can relieve the pressure on the healthcare system caused by the increasing demand for care and support. They will help people remain independent for a longer period of time. Most self-management interventions aim to improve the management of a chronic condition only, for example by taking medicines, getting exercise, eating healthily, and giving up smoking. Self-management requires more, however, than just managing one’s condition; it also involves the management of one’s health and well-being in broader sense. Dealing with an illness affects not only functional capacities and clinical outcomes, but also broader quality of life aspects, such as anxiety about the impact of an illness on oneself and family and fear about the financial impact of an illness. Paying attention to the worries and concerns of patients and investing in their abilities to cope with them are important. There is a need to focus on broader self-management abilities and overall quality of life, rather than physical functioning, disease limitations, and lifestyle behaviours alone. Examples are investing in self-efficacy and investment behaviour. Self-efficacy refers to the belief in one's abilities to complete tasks and reach goals, find agreeable activities, have friendly contact with others, and let others know that one cares about them. Investment behaviour refers to sufficiently and regularly pursuing interests (e.g., a hobby) to keep active, maintaining good contact by devoting time and attention to those who are dear, and keeping busy with the things in which one excels to remain proficient in these activities. Better self-management abilities can prevent worsening of a disease, allowing patients to maintain physical as well as mental quality of life and thereby relieving the pressure on the health care system caused by the increasing demand for care and support.
Ageing in place and the creation and maintenance of age-friendly communities is a core theme of the research group Socio-Medical Sciences. With rapid population ageing, policy makers and service providers are increasingly aware of the importance of building and maintaining age-friendly communities. We may speak of a community if individuals realize multiple well-being goals together. A community is therefore a collection of multifunctional relationships conditioned by the benefits of being a member as well as the opportunity and ease of goal realization. Living in an environment where people are trustworthy, help each other when needed (even when it is not convenient), and do not try to profit at others’ expense is expected to benefit the well-being of community-dwelling older people. Community as multifunctionality in social relations therefore refers to dependencies among neighbours to produce well-being. Solidarity among neighbours - known as the moral force of community – may thus be an important social resource on which older people can rely to help them age in place. Our research aims to enhance a comprehensive understanding of the person-environmental fit and what is needed to promote ageing in place and create age-friendly communities.
To meet the needs and protect the well-being of patients, a patient-centred system of care delivery characterised by high-quality proactive care that is organised, structured, and planned through a focus on interactions between informed, activated patients and proactive health care teams is needed. Thus, patients need to be informed (provided with sufficient information to become proactive partners and wise decision makers in their care delivery) and activated (by understanding the importance of information sharing and their roles in managing the illness). In addition, teams of health care professionals must be organised, trained, and equipped to conduct productive interactions, provide patient-centred care (PCC), and coproduce care delivery. The Socio-Medical Sciences research group investigates PCC in various settings to increase our understanding of how to improve PCC for all patient populations.
While PCC is advocated as the way to achieve coproduction of care research has shown that most patients do not feel that their level of participation in the coproduction of care is sufficient, and several difficulties occur in the establishment of productive patient–professional interaction. Failure to communicate accurately and share knowledge, or differences in treatment goals between patients and health care professionals, may lead to lack of respect and finger pointing, resulting in a lack of motivation in both parties. Although health care decisions are broadly accepted to require the integration of research evidence and individual preferences, the implementation of such approaches remains limited in practice. This situation represents a missed opportunity. Although interest in the examination of productive patient–professional interactions or coproduction of care is growing, this area of research is quite new, with a preponderance of conceptual literature. To learn more theoretically, however, we must know much more empirically. Empirical investigations of PCC, productive patient–professional interaction, and their contributions to more favourable outcomes (e.g. enhancement of satisfaction with care and well-being of patients and informal caregivers are still largely lacking. Our research group already did important research in these areas and aim to further enhance our knowledge on relational coordination and coproduction of care in the years to come. Anna Petra Nieboer and Jane Murray Cramm are faculty partners of the Relational Coordination Research Collobarative and report on evidence on relational coordination and relational coproduction of care.