Is client-centred care planning for chronic disease sustainable? Experience from rural South Australia
Box 1 Questions to determine client's problems and goals*
What do you see as your main health problem?
How does this problem change the way you live?
Are there things that you do more or less of (e.g. eat, exercise, go out, smoke or sit)?
How does this problem make you feel (e.g. angry, sad, lonely, worried or cross)?
What would you like to be able to do that the problem stops you from doing? (Is this realistic?)
How often, how long, who with?
* Questions form only one part of the overall Partners in Health approach to chronic disease self-management.
Abstract
This qualitative evaluation of a chronic disease self-management project in rural South Australia considers the sustainability of client-centred care planning under current organisational and funding arrangements. The study involved consultation with a range of five stakeholder types over two stages (40 in the beginning stage and 39 in the middle stage) about their satisfaction with the care planning and self-management approach used in the project. All stakeholder types valued the client-centred approach because they perceived that clients were better able to accept and deal with the long-term management of their condition. However, this required that care planning should deal with a wider range of issues than just medical management, and so it took longer, which raised its sustainability in general practice under the current funding through the national health insurance programme (Medicare). The study concludes that sustainability may be addressed through further research into the role of and funding for peer-led self-management groups and the employment of care planners in organisational settings that are conducive to a client-centred approach.
