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Problem solving in diabetes self-management: A model of chronic illness self-management behavior

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Annals of Behavioral Medicine

Abstract

Management of chronic illnesses is a significant public health concern that is made more challenging by problems of regimen adherence. Effective self-management of chronic illnesses such as diabetes requires not only technical skill to perform regimen behaviors but also problem-solving skills to manage daily barriers to regimen adherence and to make appropriate adjustment to the self-care regimen. A review of the empirical literature on the relation between problem solving and disease self-management in diabetes, a chronic illness exemplar, illuminates methodological limitations that indicate a need for a theoretical framework for problem solving applied to chronic disease self-management. A problem-solving model of chronic disease self-management is proposed, derived from theories of problem solving in cognitive psychology, educational al/tearning theory, and social problem solving. Four essential components of problem solving in disease self-management are identified: (a) problem-solving skill, (b) problem-solving orientation, (c) disease-specific knowledge, and (d) transfer of past experience. The model is illustrated, and empirical support for this problem-solving model in the diabetes literature is discussed. The model has utility in driving testable hypotheses regarding the relation of disease-specific problem solving to chronic illness management, in developing problem-solving assessment instruments relevant to disease self-management, and in guiding disease self-management training and interventions.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine Meyer 1-164, Johns Hopkins Hospital, 600 North Wolfe Street, 21287, Baltimore, MD

    Felicia Hill-Briggs

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  1. Felicia Hill-Briggs
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Correspondence to Felicia Hill-Briggs.

Additional information

This research was supported by National Institute of Health Supplemental Grant R01-48117-03S1 to Felicia Hill-Briggs, sponsored by Frederick L. Brancati, M.D., M.H.S., Departments of Epidemiology and Medicine, Johns Hopkins Medical Institutions.

I thank members of the behavioral diabetes research group for feedback regarding an earlier version of the problem-solving model.

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Hill-Briggs, F. Problem solving in diabetes self-management: A model of chronic illness self-management behavior. ann. behav. med. 25, 182–193 (2003). https://doi.org/10.1207/S15324796ABM2503_04

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