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Self-management in chronic diseases
We learnt from the EMPATHIE project that for person centred care to be meaningful the key lever for change from a passive recipient of paternalistic care to an active knowledgeable citizen is empowerment.
In health this means three interlinking components. Firstly, education. Health literacy is discussed in detail under the heading of ‘knowledge’ but while increased health literacy enables the citizen/patient to be a more effective active participant in their health management, education has to be two-way, something often overlooked by traditional-thinking healthcare professionals. Healthcare staff also need training in skills to promote rather than to inhibit empowerment, just as they need training in digital literacy (also dealt with under the ‘knowledge’ heading). There is now a huge literature on self-management in chronic diseases (mainly the ‘big three’ of diabetes, cardiac and circulatory disorders and respiratory diseases such as COPD and asthma). A review of systematic reviews in this area allows us to identify which approaches are most effective (see the PROSTEP project, completed 2018 and the current COMPAR-EU project, both funded by the European Commission).

EHFF is overseeing a three year project funded by the Robert Bosch Foundation to establish a European Centre for the empowerment of patients and communities
Citizen and professional relationships
If education and self-management skills are two pillars of patient empowerment, the third is joint decision-making.
From the literature and from experience, this is the least well-developed of these elements in healthcare practiced currently in Europe. There are isolated examples of excellent practice in this arena, but the fundamental issue here is a shift in the power balance and an acceptance by professionals that an educated patient is entitled to make choices, including not to have a treatment or to demand more information to allow them to agree decisions with their carers about their own health and healthcare. Key issues here are fostering mutual respect and understanding in the relationship and in professionals having confidence in their own abilities sufficient to allow them to adjust to a changed inter-personal dynamic, inevitably easier for a younger generation of professionals perhaps than for an older one.
European Patients Forum
Self-care and wellness promotion
’A learned tool enabling people to maintain health and to cope with illness and disability. Along with better health literacy it also supports optimal and timely use of available health services while avoiding a total dependency upon them for minor ailments.’
Following completion of the project, after a year of discussion a new NGO, SCiE (self-care in Europe) was set up, based in Copenhagen, in June 2019.
Wellness promotion
