Between Expectations and Reality : self-management support in nursing practice and nurse education

This thesis contributed to the understanding of the role of nurses in self-management support.
Nurses are expected to support patients with chronic conditions in their self-management, based on nursing theories and the professional profiles, but also based on expectations of policy makers. Supporting patients’ self-management, according to the broad view on self-management, is however not necessarily current practice, neither in clinical nursing practice nor in Dutch Bachelor of Nursing education. Most nurses seem to focus on the Advise phase, on medical outcomes and on ‘getting the work done’.
Reflection on nurses’ tasks is needed, since many studies in this thesis show that the Arrange phase received least attention in education, and was assigned the lowest scores in the questionnaires. Yet, the tasks in this phase represent an important aspect of self-management support and of the nursing profession. Equal partnership, which is an essential aspect of self-management support, seems to be difficult for nurses in everyday practice. Nurse education could facilitate students in empowering them and teaching them the value of patient’s expertise.