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The Chronic Disease
Self-Management Program
Chronic Disease Self Management
Tomando Control de su Salud
Washington State
Maureen Lally, MSW
WA Aging and Disability Services
My Goal Today
To underscore the belief that
individuals can manage their
chronic health conditions. By
taking control of their symptoms
people can be healthier and
What problems do you have because
of your health condition?
Have You Experienced
Other symptoms?
Even with different chronic conditions, many of the
concerns are the same.
The Vicious Symptom Cycle
of Breath
Symptom Cycle
Often fatigue and difficult emotions are common
problems experienced by people with chronic
One symptom can lead to a series of other problems
which often creates more symptoms
Which becomes a vicious symptom cycle
No known cure for many
chronic conditions
Self management or what you can do to
manage your chronic condition is very
It involves the use of various methods or
tools to manage the problems you
What is Self-Management?
“The tasks that individuals must
undertake to live with one or more
chronic conditions.”
“What people do 99.9% of the time.”
What Can You Do?
Keep informed; ask questions
Take part in planning your treatment, communicate
your preferences/goals
Inform your health care team about
problems/changes you experience
Try new things and give activities at least a 2 week
trial before deciding what works best for you
Set goals and work towards them
You Can Break The Symptom
Explore a variety of ways to:
 Regain control of your life to do the things that matter
 Have energy to do more and get relief from fatigue,
pain, and other symptoms
 Meet new people, share what you know, and learn
new ways to improve your life
 Feel better by…
 Participating in the 6 week workshop “Living Well with
Chronic Conditions”
Program Overview
Six, weekly, 2.5 hour sessions
Small group setting (10-15 people)
Practical, interactive curriculum
Led by pair of lay leaders, at least one of whom is a peer
with a chronic condition
Convenient locations
Action oriented discussion and problem solving
Supportive atmosphere
Low cost
Program Principles
Regardless of the chronic condition,
 People have similar challenges.
 Deal not only with their condition,
also with the impact of that condition on their lives.
Lay Leaders can teach the workshop
as effectively if not more effectively,
than health professionals.
Patient Education compared to
Self Management Support
Patient Education
Information and skills
are taught
Usually disease-specific
Assumes that knowledge
creates behavior change
Goal is compliance
Health care professionals
are the teachers
Self Management Support
 Skills to solve patient
identified problems are
 Methods are applied
across conditions/needs
 Assumes that confidence
yields better outcomes
 Goal is increased selfefficacy
 Teachers can be
professionals or peers
Target Populations
Adults 55 and older across the state
Eight tribes-Nooksack, Lummi, Swinomish
Quinault, Quileute, Makah, Puyallup &
Hispanic elders
African American elders
Asian communities
Senior housing communities
Rural and urban communities
The Self-Management Toolbox
Physical activity
Managing fatigue
Action Planning
Better breathing
Using your mind
Managing pain
Healthy eating
Working with health
Action Planning
•Something you want to do
• Answers the questions: What? When? How much?
and How often?
• Rated on a Confidence level of 7+ (out of 10)
Problem Solving
1. Identify the problem
2. List ideas
3. Select one
4. Assess the results
5. Substitute another idea
6. Use other resources
Evidence-Base Program Outcomes
Research indicates participants spend
• Fewer days in the hospital
• Fewer outpatient and ER visits
Participants report
• Improvement in self-reported health and
health distress
• Improvement in social life/activities
• Improved energy/less fatigue
Lorig, Ritter, et al. 2001: Sobel, Lorig & Hobbs, 2002
“I learned how to cope with things in
my life that I couldn’t handle before”
“This class kept me on track”
“I was tired. My pain was my boss.
It was telling me what I could and
couldn’t do. This workshop put ME
back in charge.”
“I learned we’re all in the same
boat, but the boat isn’t sinking.”
Contact Information
Maureen Lally
Living Well in Washington
Aging and Disability Services Administration
• 360-725-2449
• [email protected]
Stanford Patient Education Resource Center