My health, myself: a qualitative study on motivations for effective chronic disease self-management among community dwelling adults

Background: Chronic diseases continue to be a significant cause of morbidity and mortality despite modifiable risk factors. This suggests that current primary healthcare provision needs to delve beyond patient education, to understand the motivators that drive patients to undertake chronic disease self-management. Understanding these motivations within the context of a multi-cultural community can facilitate tailored support for chronic disease self-management. Objectives: To explore the motivations behind effective chronic disease self-management in community dwelling adults in Singapore. Methods: A qualitative descriptive study was carried out in five clinics in a large medical centre. Twelve participants who were assessed to be optimally managing their chronic diseases were recruited using purposive sampling. Individual in-depth interviews were conducted until data saturation, with data thematically analysed. Results: Three salient themes emerged from the data. Firstly, `Regaining self-control, avoiding complications' describes the participants' journey towards personal mastery in self-management, as well as a fear of debilitating complications resulting in their desire for good health. Secondly, 'Preserving social identities and roles' illustrates how participants yearn to maintain their preexisting roles and functions through maintenance of their health. Finally, 'Accessing proximal support systems' highlights resources and supports surrounding the participants that encourage continued chronic disease self-management. Within each theme, specific motivators and challenges encountered by participants in their self-management journey were discussed. Conclusions: Findings can prompt primary healthcare providers to leverage on the patients' life goals and social roles in chronic disease self-management support. This may empower patients to engage in self-management and strengthen primary care provision.