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American Behavioral Scientist
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Chronic Disease Self-Management

A Model for Tertiary Prevention

KATE LORIG

Stanford Patient Education Research Center

The prevalence of chronic disease continues to increase as our population ages. Today, many older people have more than one chronic condition. Thus comorbidity is a problem for both the individual and for our health care system. This article discusses the rationale and definition for a self-management model. In addition, it gives examples from both medical care and health education of how this model has been applied. Finally, it defines the key components for patient education programs built on this model. These include (a) content presentation focused on patients' perceived needs, (b) practice and feedback in new skills, including decision making and problem solving, (c) attention to emotional and role management in addition to medical management, (d) use of techniques to increase patients' confidence in their ability to manage their conditions, and (e) emphasis on the patients' active role in the physician/patient relationship.

American Behavioral Scientist, Vol. 39, No. 6, 676-683 (1996)
DOI: 10.1177/0002764296039006005
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