Self-Management:
Set and Document Self-Management Goals Collaboratively with Patients
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Identify self-management tools, including the following:
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An Asthma Action Plan that includes goals and describes behavior (e.g., using inhaler daily)
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A review of the patient’s personal barriers (e.g., forgetting to carry inhaler)
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Steps to overcome barriers
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The patient’s confidence level (ask patient: On a scale of 1 to 10, how confident are you that you can meet your goals?)
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A follow-up plan
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Review the tool with the multidisciplinary team, including all those who will be involved in its use—physicians, nurses, volunteers, lay health workers, etc.
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Test the tool with a few patients and revise as needed. Retest with additional patients and different populations.
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Establish and/or review goals with patients as part of the planned visit and follow-up.
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Assess patients’ skill, understanding, and confidence in managing their disease.
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Give patients a copy of goals, and place a copy in the chart.
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