Self-management Resources

This is the third and final article in the Long Covid (LC) series, which presents and discusses the ongoing development of the Leeds Long Covid Community Rehabilitation Service (LLCCRS), highlighting the digital interventions used to assist with symptom management
and barriers to overcome to achieve this, the importance of involving people with LC (PwLC) within service development as well as two of the most recent service evaluations of new digital interventions — virtual group assessments (VGA), and Covid-19 Yorkshire Rehabilitation Scale (C19 YRS) mobile application (app).

This article, the second in a three-part series on Long Covid (LC), focuses on how one community-based NHS LC clinic developed and now delivers a 10-week group-based virtual rehabilitation programme (VRP), which aims to provide persons with Long Covid (PwLC) concepts on current thinking in LC, alongside self-management education and support. It highlights the role of embedded clinical research fellows (CRF), and their role in an in-depth service evaluation of the VRP, using established research methods and being peer reviewed/supervised by a research team to support best practice in an evidence poor field.

The development of an integrated children’s bladder and bowel service is a key recommendation from a number of national documents and helps ensure affected children are seen at the right time and place and by the right person. This facilitates potential cost savings in the long term, with resultant reductions in A&E attendance and secondary care referrals. The key reference document is the Children’s Continence Commissioning Guide, which sets out a clear service framework. By working with several services across the UK, a generic service model has been developed which supports appropriate interventions at both tier 1 and tier 2, including the development of care pathways to help reduce unwarranted variation and inequalities in the provision of care. The key to success with this model is also the empowerment of families to help them self-manage the child’s problem, which also fits within the NHS Long Term Plan (NHS England, 2019).

The importance of an asthma review at least annually is clearly evidenced by guidelines and, importantly, was highlighted in the ‘National Review of Asthma Deaths’ report as an opportunity for assessment and education that could help prevent asthma deaths (Royal College of Physicians [RCP], 2014). Community nurses are in an ideal position to ensure that all patients with asthma have reviews. This article aims to clearly set out what these should include, give practical advice as to how to carry out an asthma UHYLHZDQGZK\WKHGLͿHUHQWHOHPHQWVRIDQDVWKPDUHYLHZ are important. 

Lipoedema is a challenging condition for patients, health and social care professionals. Lack of understanding about the condition leads to delayed diagnosis and poor support with self-management. This paper draws on key evidence, best practice guidelines for the management of lipoedema, and a patient story, to provide insights into the presentation, diagnosis, impact and management of the condition. It also identifies key points for practice for community nurses.

Chronic oedema is a soft tissue swelling present for at least three months, most commonly caused by venous and lymphatic impairment. It has a huge impact on quality of life and over time may cause social deprivation. The mainstay of treatment is compression therapy and treatment of the underlying cause. Comfort and acceptability of the compression system is essential. Clinicians need to work with patients to ensure that they are included in treatment decisions and empowered to take charge of their condition.

Chronic obstructive pulmonary disease (COPD) is a serious, long-term and irreversible disease, which obstructs airflow to the lungs due to inflammation of the air passages and lung tissue damage. The most debilitating and frightening symptom is breathlessness, which can affect an individual's ability to walk, exercise, work, socialise, sleep and eat, thus having a major impact on all activities of daily living. This article aims to provide an overview of COPD to facilitate a general understanding of the disease, assist community nurses with early identification for prompt

detection and highlight the pathways and management options available. Due to its complexity, COPD can be challenging for both patients and healthcare professionals, thus the earlier it is diagnosed and management plans started, the sooner its progression can be slowed and any impact reduced.

Psoriasis is a common, recurring inflammatory condition that affects the skin, scalp and joints. It can have a profound effect on an individual’s self-image, self-esteem, and sense of well-being and can negatively affect all aspects of life.

This paper will outline the physiological and psychological impact of psoriasis on the individual and discuss its subsequent impact on adherence to treatment. It will also examine the benefits of self-management of long-term conditions, such as psoriasis and look at the role nurses can play in helping to support self-management.

Susan Maguire, RN, BA (Hons), Professional Officer, British Dermatological Nursing Group, 88 Kingsway, London WC2B 6AA

Article accepted for publication: February 2012

Anne Williams discusses the literature around self-care and self-management in lymphoedema, and considers the implications for supporting people with lymphoedema.

Anne Williams RGN, MSc, RNT, DN, Onc Cert is a PhD Student, Edinburgh Napier University.

Article accepted for publication: March 2010