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An ongoing process of inner negotiation – a Grounded Theory study of self-management among people living with chronic illness
Mittuniversitetet.
Sundsvalls sjukhus.
Mittuniversitetet, Universitetet i Tromsø.
Umeå universitet.
2009 (English)In: Journal of Nursing and Healthcare of Chronic Illness, ISSN 1752-9816, E-ISSN 1752-9824, Vol. 1, no 4, 283-293 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to better understand the main concern of self-management processes among people with chronic illness.

Background: One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches.

Method: The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure.

Results: Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual’s considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model.

Conclusions: The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding.

Relevance to clinical practice: This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness.

Place, publisher, year, edition, pages
2009. Vol. 1, no 4, 283-293 p.
Keyword [en]
Chronic disease, Self-care, Health beliefs, Qualitative, Grounded Theory
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-5541DOI: 10.1111/j.1752-9824.2009.01039.xOAI: oai:DiVA.org:esh-5541DiVA: diva2:1065512
Projects
Exploring individuals’ conceptions as a way to understand self-managment among people living with long term medical conditions
Available from: 2009-12-01 Created: 2016-11-30 Last updated: 2017-02-14Bibliographically approved

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