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Who's in charge? The role of responsibility attribution in self-management among people with chronic illness
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Department of Public Health and Research, Sundsvall Hospital, Sweden.
2010 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 81, no 1, p. 94-100Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To explore how responsibility attribution influences self-management regimens among people with chronic illness. METHODS: This qualitative content analysis included 26 interviews with people living with chronic illness. RESULTS: The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes. CONCLUSION: How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility. PRACTICE IMPLICATIONS: Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.

Place, publisher, year, edition, pages
Elsevier , 2010. Vol. 81, no 1, p. 94-100
Keywords [en]
Self-management; chronic disease; decision-making; qualitative; interviews; content
National Category
Nursing
Identifiers
URN: urn:nbn:se:miun:diva-10661DOI: 10.1016/j.pec.2009.12.007ISI: 000282070900016PubMedID: 20060256Scopus ID: 2-s2.0-77955920242OAI: oai:DiVA.org:miun-10661DiVA, id: diva2:280968
Projects
Exploring individuals' conceptions as a way to understand self-management among people living with long term medical conditions.Available from: 2009-12-14 Created: 2009-12-14 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Being creative and resourceful: Individuals’ abilities and possibilities for self-management of chronic illness
Open this publication in new window or tab >>Being creative and resourceful: Individuals’ abilities and possibilities for self-management of chronic illness
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Att vara kreativ och resursstark : Individers förmåga och möjlighet till egenvård av kronisk sjukdom
Abstract [en]

Individuals’ self-management styles are crucial for how they manage to live with illness. Commonly investigated factors include social support, self-efficacy, health beliefs, and demographics. There is a gap in the literature with regard to in-depth studies of how those factors actually influence an individual’s self-management.

 

The aim of this thesis was to investigate the underlying mechanisms of self-management from the perspective of individuals living with chronic illness.

 

Interviews were conducted with 47 individuals with various chronic illnesses, some of them repeatedly over two and a half years (a total of 107 interviews). The material was analysed with; constructive grounded theory, content analysis, phenomenography, and interpretive description.

 

The Self-management Support Model identified aspects that influenced participants’ self-management: economic and social situation, social support, views and perspectives on illness, attribution of responsibility, and ability to integrate self-management into an overall life situation. For example, individuals with a life-oriented or disease-oriented perspective on illness prioritized different aspects of self-management. People who attributed internal responsibility performed a more complex self-management regimen than individuals who attributed external responsibility. In conclusion, individuals who were creative and resourceful had a better chance of tailoring a self-management regimen that suited them well. People in more disadvantaged positions (e.g., financial strain, limited support, or severe intrusive illness) experienced difficulty in finding a method of self-management that fit their life situation.

 

These findings can inspire healthcare providers to initiate a reflective dialogue about self-management with their patients.

Place, publisher, year, edition, pages
Sundsvall: Mittuniversitetet, 2011. p. 82
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 109
Keywords
Self-management, self-care, chronic illness, chronic disease, qualitative research, life conditions, beliefs and values, self-management integration, longitudinal, Egenvård, sjukdomshantering, kronisk sjukdom, kvalitativ forskning, livsvillkor, värderingar, egenvårds integrering, hantering, anpassning
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-13512 (URN)978-91-86694-39-5 (ISBN)
Public defence
2011-05-13, Lubbesalen, M108, Mittuniversitetet, Sundsvall, 10:15 (Swedish)
Opponent
Supervisors
Projects
Exploring individuals’ conceptions as a way to understand self-management among people living with long term medical conditions
Available from: 2011-04-13 Created: 2011-04-12 Last updated: 2012-07-30Bibliographically approved

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Audulv, ÅsaAsplund, KennethNorbergh, Karl-Gustaf

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