چکیده (انگلیسی):

Background:Primary care professionals are presumed to play a central role in delivering long-term condition
management. However the value of their contribution relative to other sources of support in the life worlds of
patients has been less acknowledged. Here we explore the value of primary care professionals in people’s personal
communities of support for long-term condition management.
Methods:A mixed methods survey with nested qualitative study designed to identify relationships and social
network member’s (SNM) contributions to the support work of managing a long-term condition conducted in 2010
in the North West of England. Through engagement with a concentric circles diagram three hundred participants
identified 2544 network members who contributed to illness management.
Results:The results demonstrated how primary care professionals are involved relative to others in ongoing self-care
management. Primary care professionals constituted 15.5 % of overall network members involved in chronic illness
work. Their contribution was identified as being related to illness specific work providing less in terms of emotional
work than close family members or pets and little to everyday work. The qualitative accounts suggested that primary
care professionals are valued mainly for access to medication and nurses for informational and monitoring activities.
Overall primary care is perceived as providing less input in terms of extended self-management support than the
current literature on policy and practice suggests. Thus primary care professionals can be described as providing
‘minimally provided support’. This sense of a ‘minimally’ provided input reinforces limited expectations and value about
what primary care professionals can provide in terms of support for long-term condition management.
Conclusions:Primary care was perceived as having an essential but limited role in making a contribution to support
work for long-term conditions. This coalesces with evidence of a restricted capacity of primary care to take on the work
load of self-management support work. There is a need to prioritise exploring the means by which extended self-care
support could be enhanced out-with primary care. Central to this is building a system capable of engaging network
capacity to mobilise resources for self-management support from open settings and the broader community.