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Self Management

PRISMS Taxonomy

The PRISMS taxonomy is a classification system for components of SM support developed by Pearce and colleagues; it is commonly used as a framework for the design and description of SM interventions, synthesis of evidence, and development of health care with long-term conditions. The taxonomy consists of 14 components, which are described in detail in Table 8.

Abbreviated Code Code Description
Condition Information about condition and/or its management Providing patients with information about their conditions or about the essential aspects and principles of managing their conditions (e.g., information sessions on medication management).
Resources Information about available resources Provision of written, verbal, or visual information on available social service and healthcare resources (e.g., advice on how to access financial assistance and accessible transportation).
Plan Provision of/agreement on specific clinical action plans and/or rescue medication Individualized written instructions prepared by a health-care professional that enable patients to manage their conditions (e.g., action plan on how to recognize certain symptoms and what actions to take).
Review Regular clinical review A regular and scheduled review conducted by a healthcare professional, on the patient, their condition, and SM (e.g., regular clinical visits conducted by health professionals).
Monitoring Monitoring of condition with feedback Monitoring symptoms, behaviours, or objective measures related to the patient’s condition, done by the patient or others; the patient receives the results of the monitoring and take actions accordingly, sometimes with the guidance from health professionals (e.g., the completion of daily logs to monitor symptoms).
Adherence Practical support with adherence (medication or behavioural) Providing patients with practical help to improve adherence to medication or behaviour change activities (e.g., reminder phone calls for taking medication).
Equipment Provision of equipment Providing patients with equipment to enable, assist or promote SM and/or self-monitoring of their condition (e.g., the provision of assistive technology that enables people with SCI to use computers).
Advice Provision of easy access to advice or support when needed **Safety Netting Provision of access to health services and advice from health professionals when urgent or non-urgent concerns arise (e.g., providing contact information of a specialist nurse helpline).
Professionals Training/rehearsal to communicate with healthcare professionals Helping patients build and practise necessary skills that enable them effectively communicate their needs and collaborate with health professionals (e.g., advocacy skill training workshop).
Everyday Training/rehearsal for everyday activities **ADLs Enabling patients to build and/or practice skills that support everyday activities (e.g., OT activities such as washing and dressing practice).
Practical Training/rehearsal for practical self-management activities Teaching patients practical skills that help them manage their conditions and/or providing patients with opportunities to practise those skills (e.g., home exercise for pressure ulcer management).
Psychological Training/rehearsal for psychological strategies Provision of psychological strategies training that help mitigate the impact of the health conditions and/or providing patients with the opportunity to practice the skills they have learned (e.g., cognitive restructuring).
Social Social support Helping patients build and/or strengthen the connection with their social support network (e.g., peer support groups).
Lifestyle Lifestyle advice and support Providing patients with advice and support related to health and lifestyle (e.g., advice on physical activity and diet).

Figure 5 shows the percentage of studies included in this review using each of the components from PRISMS taxonomy. The focus on information provision and psychosocial interventions in the existing SM programs for SCI is also evident in the percentage distribution under each PRISMS taxonomy component. Information about condition and /or its management was the most widely utilized component and was used in more than three quarters (79.4%) of the programs, followed by training/ rehearsal for psychological strategies (54.8%), lifestyle advice and support (45.2%), and social support (42.1%). The least used program components were provision of equipment (4.0%), training/rehearsal to communicate with healthcare professionals (4.0%), and regular clinical review (2.4%).

Figure 5. Percentage of studies using each of the components from PRISMS
taxonomy
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