Understanding New Zealand physiotherapy scholars' philosophies and practices of supported self-management: a qualitative study.

Abstract

The growing prevalence of long-term health conditions has intensified focus on self-management to ease burdens on individuals and health systems. Yet, its meaning remains ambiguous, encompassing individual responsibility, resource provision, and professional support. Physiotherapists are well positioned to support self-management, but how this occurs in practice is unclear. This study examined New Zealand physiotherapy scholars' philosophies, interpretations, and delivery of supported self-management. Using the qualitative methodology of Interpretive Description, 14 semi-structured interviews were conducted and thematically analysed. Three themes were constructed: (1) <i>Role of physiotherapy in supported self-management</i>, considered important and integral to patient wellbeing but not fully embraced. (2) <i>Components of supported self-management</i>, viewed as central to person-centred care, included strategies of skill-building, enabling environments, and psychologically-informed tools strengthening patient self-efficacy. (3) <i>Complexities of implementation</i> spoke to how systemic barriers, particularly financial and time constraints, limits implementation. Targeted training and practical tools were identified as essential for improving implementation. Physiotherapist scholars appeared to endorse and/or engage with supporting self-management; however, there was a continuum of what this meant and how such support was delivered. Given that support requirements fluctuate, we suggest physiotherapists maintain a critically reflective stance and demonstrate flexibility to accommodate these inherent uncertainties.