Self-Management Education: History, Definition, Outcomes, and Mechanisms
Kate R. Lorig, Dr.P.H. and Halsted R. Holman, M.D.
Stanford University School of Medicine

ABSTRACT

THE MEANING OF SELF-MANAGEMENT

Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks—medical management, role management, and emotional management—and six self-management skills—problem solving, decision making, resource utilization, the formation of a patient–provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems.

Whether one is engaging in a health promoting activity such as exercise or is living with a chronic disease such as asthma, he or she is responsible for day-to-day management.
Gregory Bateson (3) once said, “one cannot not communicate.”
The same is true for health behavior and disease management.
One cannot not manage. If one decides not to engage in a healthful behavior or not to be active in managing a disease, this decision reflects a management style. Unless one is totally ignorant of healthful behaviors it is impossible not to manage one’s health. The only question is how one manages. The issue of self-management is especially important for those with chronic disease, where only the patient can be responsible for his or her day-to-day care over the length of the illness. For most of these people, self-management is a lifetime task.

(Ann Behav