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It is
vital to understand that long-term conditions (LTC) are recognized as
conditions which are not curable, but can be managed through forms of
medications and other treatments (Naylor et al.,
2012). Around 30% of the population in England (15 million people) have one or
multiple LTC, as predictions have stated figures to continue to rise (Edwards
et al., 2012). Recent reports (e.g. NHS Confederation, Kings Fund and Coalition
for Collaborative Care) have highlighted that the NHS need to develop major
changes to respond effectively to the number of people living with LTC
increases (Kennedy et al., 2013). This includes further changes the way in
which services have been organised to deliver greater emphasis to target
interventions/strategies to help individuals manage their LTC (Small et al.,
2013). One psychological approach which is widely used is the Self-Regulatory
Model of Illness Behaviour or commonly known as the common-sense model (CSM). This
approach proses the response to illness or health threats which people form
their own common-sense of illness beliefs/perceptions about their condition and
treatment. Illness beliefs have influence towards the types of health-related
behaviours as well as coping behaviours in the ways individuals manage their
conditions which impact their illness health outcome (Leventhal et al., 2003).
The CSM suggests they cover five broad dimensions: identity, timeline, causes,
consequences and curability/controllability (Lau & Hartman, 1983). People’s
illness beliefs of their diabetes have found to be influential on
self-management behaviours, which may have an impact on glycaemic control (Griva
et al., 2000). People who have poor control of their diabetes have found to
distinctly have different beliefs on their LTC compared to those in good
control. This was evidently shown in research which found that compared to
patients in good control with their diabetes; those with poor control had shown
stronger beliefs that their illness was caused by genetic factors, suffered
from more symptoms diabetic-related, perceived diabetes to have a significant
impact to their lives, and more report on negative emotions in relation to
their illness/LTC (White et al., 2007).

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Research which has used CSM has found beliefs about diabetes
to be an important role to instigating illness management, as well as
interventions to either challenge or change beliefs (Philips et al., 2012).
However, research which has used CSM has been conducted on those who are
Europeans or Caucasian (Bames et al., 2004). Qualitative studies were able to
provide an insight into casual beliefs abut diabetes as well as self-management
behaviours in this population.  For
example, controlling intake of sugar, followed by information which may be
provided by General Practitioner (GP) and passive beliefs (attributing diabetes
control towards God and believing that deities have more power in controlling
illness and health) have relation towards self-management of diabetes, although
these factors require explanation within the domains of CSM (Fleming &
Gillibrand, 2009). Success to self-management requires better understanding of
diabetes. However, poor understanding and cultural health beliefs of diabetes
have reported to hinder self-management practises, which results in poor
outcomes of diabetes (Stone et al., 2010). Educational programmes tailored to
diabetes have been designed to improve diabetes self-management in British
South Asian have had limited success to improving diabetes outcome. Given that
there is an elevated risk of diabetes in the population, more compete
explanation is needed to have better knowledge to understanding the underlying
illness beliefs about diabetes and self-management (Zeh et al., 2012). To
manage illness, this is often shared involving the patients family or friends,
and is likely that the beliefs about diabetes influenced this context. Strong
family ties in South Asian populations have shown a link to shaping illness
beliefs and delivery of information about diabetes (Searle et al., 2007).

In consideration to the background knowledge in understanding
illness beliefs and CSM, this essay will explore the ways in which illness
beliefs and behaviours can promote or hinder the management of diabetes through
the role of family, education and empowerment for self-management.

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