Perceived quality of chronic illness care is associated with self-management: Results of a nationwide study in the Netherlands

- Nurses' involvement in chronic illness care is associated with better quality of care.
- However, nurses' involvement is not associated with higher self-management levels.
- Patients' experiences with better quality of chronic illness care relates to higher self-management levels.
- Implementing high-quality chronic illness care seems worthwhile to enhance self-management.

BackgroundHealthcare providers are increasingly expected to help chronically ill patients understand their own central role in managing their illness. The aim of this study was to determine whether experiencing high-quality chronic illness care and having a nurse involved in their care relate to chronically ill people's self-management.MethodsSurvey data from 699 people diagnosed with chronic diseases who participated in a nationwide Dutch panel-study were analysed using linear regression analysis, to estimate the association between chronic illness care and various aspects of patients' self-management, while controlling for their socio-demographic and illness characteristics.ResultsChronically ill patients reported that the care they received was of high quality to some extent. Patients who had contact with a practise nurse or specialised nurse perceived the quality of the care they received as better than patients who only had contact with a GP or medical specialist. Patients' perceptions of the quality of care were positively related to all aspects of their self-management, whereas contact with a practise nurse or specialised nurse in itself was not.ConclusionChronically ill patients who have the experience to receive high-quality chronic illness care that focusses on patient activation, decision support, goal setting, problem solving, and coordination of care are better self-managers. Having a nurse involved in their care seems to be positively valued by chronically ill patients, but does not automatically imply better self-management.