"I see myself very much as a knowledge worker": An interpretive description study of healthcare professionals' experiences of supporting self-management among people with long-term conditions in Greenland.

OBJECTIVE

Self-management support is central to long-term condition care, yet little is known about how healthcare professionals support self-management in everyday clinical practice in Arctic healthcare settings. This study explored how healthcare professionals in Greenland understand and enact support for self-management among individuals with chronic obstructive pulmonary disease (COPD) or type 2 diabetes and examined how these practices relate to principles of self-management support.

METHODS

An inductive qualitative study used Interpretive Description. Semi-structured, face-to-face interviews were conducted with 23 healthcare professionals across the Greenlandic healthcare system. Data were analysed iteratively to generate practice-relevant interpretations. An integrative conceptual overview was developed to synthesise the relationships between themes and contextual conditions that shape support for self-management.

RESULTS

Four interrelated themes were identified. First, support for self-management was primarily informal, embedded in routine clinical encounters and focused on biomedical explanations rather than structured, action-oriented strategies. Second, relational and empathetic practices, including non-judgemental communication and trust-building, were described as essential for patient engagement but were enacted intuitively rather than systematically. Third, participants described support for self-management as requiring a broad and evolving set of skills; however, limited access to timely specialist support and fragmented organisational structures constrained practice in complex situations. Fourth, language and cultural factors shaped communication and understandings of illness, highlighting challenges related to multilingual clinical encounters and perceptions of health, responsibility, and agency.

CONCLUSION

In Greenlandic healthcare, support for self-management was described as largely informal, with a focus on biomedical knowledge, and embedded in routine clinical encounters. Current practices appeared to place greater emphasis on biomedical education than on structured, action-oriented and everyday-life-oriented components of self-management support. Strengthening self-management support may therefore benefit from an organisational health literacy approach that supports healthcare professionals in complementing biomedical explanations with pedagogically informed, action-oriented and contextually responsive support.