Healthcare professionals are urged to challenge the stage model of adjustment as a way of understanding the response to illness and to listen instead to the stories people tell. They are encouraged to privilege the person's experience as the basis for developing a sensitive, client-focussed response that takes into account the wider social context of people's lives as well as the medical aspects.

It is vital for healthcare workers to give opportunities for women to talk about fatigue, validate their experiences and provide support with self-care. Healthcare workers are encouraged to challenge their own meanings and expectations surrounding a person's report of fatigue so that opportunities for therapeutic intervention can be facilitated.

This paper reveals that issues of sexuality are an important health concern for women who live with long-term illness and should be acknowledged in sensitive and responsive health practices. The paper concludes that it is important for nurses to provide women opportunity for open and genuine communications about sexuality. In this way, a foundation of acceptance for the whole person is established which provides women permission to ask questions and seek assistance with sexuality issues.

kralik d, price k & telford k (2010)  Journal of Nursing and Healthcare of Chronic Illness2, 197–204
The meaning of self‐care for people with chronic illness Aim.  To reveal the meaning of self‐care as described by men and women living with chronic conditions. Background.  Chronic illness self‐care and self‐management are terms that have been used interchangeably in the literature. Self‐care in the context of chronic illness has received some research attention, but remains an under‐explored concept. Methods.  Conversation data were gathered using longitudinal email groups facilitated by the first author over a 21‐month period between 2003–2005, with 42 men and women living with chronic illness. Results.  Self‐care is a process of adaptation in response to learning about oneself and about ways to live well with illness. Developing capacity to self care impacted significantly on the way participants experienced illness, their view of themselves and of their future. Conclusions.  People living with chronic illness describe the process of self‐care as transformational in terms of feelings about their selves and reclaiming a sense of order. It enables them to move forward with a sense of the future. The primary health care principle of holistic assessment, taking account of the wider context of people’s lives, is of heightened importance when educating about self‐care. Relevance to clinical practice.  Health care workers can assist people by acknowledging that chronic illness self‐care is a process that gradually evolves and is borne out of listening to the person’s priorities and finding ways for strategies to fit harmoniously alongside those priorities.

Change management has been recognised as a complex, dynamic process during which unanticipated events and behaviour may emerge. This is particularly the case for community health care organisations where the combination of a number of typical features serves to complicate change efforts. Change in complex organisations such as community health services is unlikely to be a straightforward process and is likely to require more than one approach. This review examines the various change management approaches in the literature, with a view to assessing their relevance to a community health organisational context. Debate around the strengths and limitations are reported along with the key elements of responsive change management processes.

No abstract