'Well, who do I phone?' Preparing for urgent care: a challenge for XXXX and service providers alike'.

@entity1 @entity6
AIMS AND OBJECTIVES: To investigate factors influencing @entity1 ' self-management of urgent @entity6 problems that precipitated unscheduled hospital care. BACKGROUND: @entity6 is placing increasing resource demands on health services and current policy advocates management in primary care and community settings whenever possible. Such policy has implications for @entity1 education and empowerment and on mechanisms within primary and community care to support the management of @entity6 when urgent healthcare problems arise. DESIGN: Qualitative, descriptive investigation, across two contrasting sites. METHODS: Forty-five @entity1 admitted to hospital for urgent/emergency care due to @entity6 were recruited from urban and rural localities in the UK. Semi-structured interviews were conducted and data analysed using nvivo version 8 and framework techniques. RESULTS: Self-management of @entity6 was typically habitual, and urgent problems that proved difficult to resolve necessitated recourse to unscheduled hospital care. Though skills relating to problem-solving, decision-making, resource use and formation of @entity1 -provider partnerships were evident among some @entity1 , these required further development. Evidence of action planning or self-tailoring skills was sparse. CONCLUSIONS: Education plays an important role in assisting individuals to self-manage their @entity6 on a daily basis, but urgent, unexpected health problems proved challenging for both @entity1 and health service providers. A greater focus on empowering @entity1 with core self-management skills is required to enhance ability to successfully manage unexpected @entity6 complications, coupled with enhanced primary care resources, particularly out-of-hours. RELEVANCE TO CLINICAL PRACTICE: The importance of informal and structured @entity6 education should not be underestimated; however, the challenge of improving skills such as problem-solving to manage urgent healthcare needs must be tackled. This study provokes debate regarding how best to deliver appropriate education and health services to cover urgent unscheduled care needs without automatically referring to emergency department hospital care.
