<unk>  management is defined as the response to signs and symptoms when they occur.<unk>  management involves the evaluation of physical and emotional changes and deciding if these changes need to be addressed. Changes may occur because of illness, treatment, or the environment. Once treatment is complete, it should be evaluated to judge whether it would be useful to repeat in the future. Treatments are based on the signs and symptoms experienced. Treatments are usually specific to the illness.<unk>  management includes recognizing symptoms, treating the symptoms, and evaluating the treatment.<unk>  management behaviors are symptom- and disease-specific. For example, a patient with asthma may recognize the symptom of shortness of breath. This patient can manage the symptom by using an inhaler and seeing if their breathing improves. A patient with heart failure manages their condition by recognizing symptoms such as swelling and shortness of breath.<unk>  management behaviors for heart failure may include taking a water pill, limiting fluid and salt intake, and seeking help from a healthcare provider. Regular<unk>  monitoring is needed to identify symptoms early and judge the effectiveness of treatments. Some examples include: *Inject insulin in response to high blood sugar and then re-check to evaluate if blood glucose lowered *Use social support and healthy leisure activities to fight feelings of social isolation. This has been shown to be effective for patients with chronic lung disease Barriers to management Access to<unk> : Access to<unk>  is a major barrier affecting<unk>  management. Treatment of symptoms might require consultation with a healthcare provider. Access to the health-care system is largely influenced by providers. Many people suffering from a chronic illness do not have access to providers within the health-care system for several reasons. Three major barriers to<unk>  include: insurance coverage, poor access to services, and being unable to afford costs. Without access to trained health<unk>  providers, outcomes are typically worse. Financial constraints: Financial barriers impact<unk>  management. The majority of insurance coverage is provided by employers. Loss of employment is frequently accompanied by loss of health insurance and inability to afford health<unk> . In patients with diabetes and chronic heart disease, financial barriers are associated with poor access to<unk> , poor quality of<unk> , and vascular disease. As a result, these patients have reduced rates of medical assessments, measurements of Hemoglobin A1C (a marker that assesses blood glucose levels over the last 3 months), cholesterol measurements, eye and foot examinations, diabetes education, and aspirin use. Research has found that people in higher social classes are better at<unk>  management of chronic conditions. In addition, people with lower levels of education often lack resources to effectively engage in<unk> -management behaviors. Age: Elderly patients are more likely to rate their symptoms differently and delay seeking<unk>  longer when they have symptoms. An elderly person with heart failure will experience the symptom of shortness of breath differently than someone with heart failure who is younger. Providers should be aware of the potential delay in provider-seeking behavior in elderly patients which could worsen their overall condition. Prior experience: Prior experience contributes to the development of skills in<unk>  management. Experience helps the patient develop cues and patterns that they can remember and follow, leading to reasonable goals and actions in repeat situations. A patient who has skills in<unk> -management knows what to do during repeated symptomatic events. This could lead to them recognizing their symptoms earlier, and seeking a provider sooner. Health<unk>  literacy: Health<unk>  literacy is another factor affecting<unk>  management. Health<unk>  literacy is the amount of basic health information people can understand. Health<unk>  literacy is the major variable contributing to differences in patient ratings of<unk> -management support. Successful<unk>  involves understanding the meaning of changes in one's body. Individuals who can identify changes in their bodies are then able to come up with options and decide on a course of action. Health education at the patient's literacy level can increase the patient's ability to problem solve, set goals, and acquire skills in applying practical information. A patient's literacy can also affect their rating of healthcare quality. A poor healthcare experience may cause a patient to avoid returning to that same provider. This creates a delay in acute symptom management. Providers must consider health literacy when designing treatment plans that require<unk> -management skills. Co-morbid conditions: A patient with multiple chronic illnesses may experience compounding effects of their illnesses. This can include worsening of one condition by the symptoms or treatment of another. People tend to prioritize one of their conditions. This limits the<unk>  management of their other illnesses. One condition may have more noticeable symptoms than others. Or the patient may be more emotionally connected to one illness, for example, the one they have had for a long time. If providers are unaware of the effect of having multiple illnesses, the patient's overall health may fail to improve or worsen as a result of therapeutic efforts. Interventions to improve management There are many ways for patients and healthcare providers to work together to improve patients and<unk> givers'<unk>  management. Stoplight and skill teaching allow patients and providers to work together to develop decision-making strategies. Stoplight is an action plan for the daily treatment of a patient's chronic illness created by the healthcare team and the patient. It makes decision making easier by categorizing signs and symptoms and determining the appropriate actions for each set. It separates signs and symptoms into three zones: * Green is the safe zone, meaning the patient's signs and symptoms are what is typically expected. The patient should continue with their daily<unk>  tasks, such as taking daily medications and eating a healthy diet. * Yellow is the caution zone, meaning the patient's signs and symptoms should be monitored as they are abnormal, but they are not yet dangerous. Some actions may need to be taken in this zone to go back to the green zone, for instance taking additional medication. The patient may need to contact their healthcare team for advice. * Red is the danger zone, meaning the patient's signs and symptoms show that something is dangerously wrong. If in this category the patient needs to take actions to return to the green category, such as taking an emergency medication, as well as contact their healthcare team immediately. They may also need to contact emergency medical assistance. The stoplight plan helps patients to make decisions about what actions to take for different signs and symptoms and when to contact their healthcare team with a problem. The patient and their provider will customize certain signs and symptoms that fit in each stoplight category. Skills teaching is a learning opportunity between a healthcare provider and a patient where a patient learns a skill in<unk>  unique to his or her chronic illness. Some of these skills may be applied to the daily management of the symptoms of a chronic illness. Other skills may be applied when there is an exacerbation of a symptom. A patient newly diagnosed with persistent asthma might learn about taking oral medicine for daily management, control of chronic symptoms, and prevention of an asthma attack. However, there may come a time when the patient might be exposed to an environmental trigger or stress that causes an asthma attack. When unexpected symptoms such as wheezing occur, the skill of taking daily medicines and the medicine that is taken may change. Rather than taking oral medicine daily, an inhaler is needed for quick rescue and relief of symptoms. Knowing to choose the right medication and knowing how to take the medicine with an inhaler is a skill that is learned for the<unk>  management of asthma. In skills teaching, the patient and provider need to discuss skills and address any lingering questions. The patient needs to know when and how a skill is to be implemented, and how the skill may need to be changed when the symptom is different from normal. See the summary of tactical and situational skills above. Learning<unk>  management skills for the first time in the<unk>  of a chronic illness is not easy, but with patience, practice, persistence, and experience, personal mastery of<unk>  skills can be achieved. Support can include: *<unk>  information on health and human body systems, lifestyle and healthy eating. * Support to capture, manage, interpret, and report observations of daily living (ODLs), the tracking of trends, and the use of the resulting information as clues for<unk>  action and decision making. * Information prescriptions providing personalised information and instructions to enable an individual to<unk>  and take control of their health *<unk>  and<unk> -monitoring devices and assistive technology. *<unk>  skills and life skills training programmes and courses for people. * Advice from licensed counselors, clinical social workers, psychotherapists, pharmacists, physiotherapists and complementary therapists. *<unk>  support networks which can be face to face or virtual, and made up of peers or people who want to provide support to others or receive support and information
Self-care
Toileting
Clean living movement
Activities of daily living
Heal 
Barrier nursing
Nursing
Motor skill