[Nursing and self-help in the context of chronic illness and disability]

The promotion and maintenance of independence of chronically ill or handicapped people are particular objectives of professional nursing as well as coping in self-help groups. Accordingly, nursing and self-help may complement each other in the care for chronically ill or handicapped people. Evidence suggests that self-help groups contribute to health related knowledge, mutual aid and social support as well as modifications of attitudes of the group members and their social environment. They disburden the primary social networks and families of the afflicted persons and reinforce the "intelligent" utilisation of the professional services of the health care system. Nevertheless, the integration of self-help initiatives in the health care system is precarious. The co-operation between self-help groups and the professional health care system is characterised by an imbalance between medical laymen and experts. Nursing staff in hospitals are important co-operation partners and contact persons for self-help groups. To understand better the effects of self-help groups, longitudinal studies with non-randomised comparison groups are needed. Further research should address the questions, how larger proportions of the population can be involved in self-help activities and how the relevance of self-help differs in various diagnosis groups. Research in the area of self-help is fragmented; research promotion and co-ordination in this area appear to be necessary.