TY - JOUR T1 - A qualitative study of GPs' attitudes to self-management of chronic disease JF - British Journal of General Practice JO - Br J Gen Pract SP - 407 LP - 414 VL - 56 IS - 527 AU - Tom Blakeman AU - Wendy Macdonald AU - Peter Bower AU - Claire Gately AU - Carolyn Chew-Graham Y1 - 2006/06/01 UR - http://bjgp.org/content/56/527/407.abstract N2 - Background Improving the quality of care for patients living with a chronic illness is a key policy goal. Alongside systems to ensure care is delivered according to evidence-based guidelines, an essential component of these new models of care is the facilitation of self-management. However, changes to the way professionals deliver care is complex, and it is important to understand the key drivers and barriers that may operate in the primary care setting.Aim To explore GPs' perspectives on their involvement in the facilitation of chronic disease self-management.Design of study Qualitative study.Setting General practices located in two primary care trusts in northern England.Method Data were collected through in-depth, semi-structured interviews with a purposive sample of GPs. During analysis, categories of response were organised into themes that relate to Howie's theoretical model for understanding general practice consultations: content, values, context.Results The GPs' responses highlighted tensions and trade-offs regarding their role in facilitating self-management. Although GPs valued increased patient involvement in their health care, this was in conflict with other values concerning professional responsibility. Furthermore, contextual factors also limited the degree to which they could assist in encouraging self-management.Conclusions Providing GPs with training in consultation skills is required in order to encourage the delivery of effective self-management. In addition, the context in which GPs work also needs to be modified for this to be achieved. ER -