Patients, persons or partners? Involving those with chronic disease in their care

Abstract

Self-care management is essential for effective chronic disease management. Yet prevailing approaches of healthcare practitioners often undermine the efforts of those who require on-going medical attention for chronic conditions, emphasizing their status as patients, failing to consider their larger life experience as people, and most importantly, failing to consider them as people with the potential to be partners in their care. This article explores two approaches for professional-patient interaction in chronic disease management, namely, patient-centred care and empowering partnering, illuminating how professionals might better interact with chronically ill individuals who seek their care. The opportunities, challenges, theory and research evidence associated with each approach are explored. The advantages of moving beyond patient-centred care to the empowering partnering approach are elaborated. For people with chronic disease, having the opportunity to engage in the social construction of their own health as a resource for everyday living, the opportunity to experience interdependence rather than dependence/independence throughout on-going healthcare, and the opportunity to optimize their potential for self-care management of chronic disease are important justifications for being involved in an empowering partnering approach to their chronic disease management.

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

“…The findings of this study also afford insights into the meaning of a positive client-nurse relationship as being connected , illuminated in greater depth as feeling a personal interest , connecting as friends , and feeling like a person, not a patient. This insight is congruent with previous research (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; McWilliam, 2009; McWilliam et al, 1997; Miner-Williams, 2007; Nolan et al, 2003; Schoot et al, 2005) related to connectedness in the client-nurse relationship. More specifically, several authors (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; Nolan et al, 2003; Schoot et al, 2005) have found that clients expect to be recognized and valued as a person of worth within this relationship and wish to be understood as an individual human being, apart from their illness.…”

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

“…The findings of this study also afford insights into the meaning of a positive client-nurse relationship as being connected , illuminated in greater depth as feeling a personal interest , connecting as friends , and feeling like a person, not a patient. This insight is congruent with previous research (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; McWilliam, 2009; McWilliam et al, 1997; Miner-Williams, 2007; Nolan et al, 2003; Schoot et al, 2005) related to connectedness in the client-nurse relationship. More specifically, several authors (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; Nolan et al, 2003; Schoot et al, 2005) have found that clients expect to be recognized and valued as a person of worth within this relationship and wish to be understood as an individual human being, apart from their illness.…”

Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care

“…In keeping with the findings of this study, the relevance of the art of “relational inquiry” (Doane & Varcoe, 2008) and mutual conscious attention to connecting “at the hyphen” (Buber, 1958) throughout care has been explicated by others (McWilliam, 2009). However, the empirical and theoretical literature also illuminates how paid provider-client connectedness may be constrained by traditional health care practice that creates and maintains relational boundaries with clients (Gantert et al, 2009), a process known as professional “distancing” and “othering” (Boreus, 2006).…”

How do community pharmacists conceptualise and operationalise self-care support of long-term conditions (LTCs)? An English cross-sectional survey

“…The theory and practice of patient‐centredness in the healthcare professional‐patient consultation has been strongly promoted by research and policy if the principles of self‐care support in the management of LTCs is to be adopted in practice . Paternalism which used to be the dominant model of consultation between healthcare professionals and patients is now viewed as detrimental to improving self‐care and overall patient health . Active and empowering partnerships between healthcare professionals and patients are a pre‐requisite for patient‐centred and quality healthcare .…”

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

“…The findings of this study also afford insights into the meaning of a positive client-nurse relationship as being connected , illuminated in greater depth as feeling a personal interest , connecting as friends , and feeling like a person, not a patient. This insight is congruent with previous research (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; McWilliam, 2009; McWilliam et al, 1997; Miner-Williams, 2007; Nolan et al, 2003; Schoot et al, 2005) related to connectedness in the client-nurse relationship. More specifically, several authors (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; Nolan et al, 2003; Schoot et al, 2005) have found that clients expect to be recognized and valued as a person of worth within this relationship and wish to be understood as an individual human being, apart from their illness.…”

Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care

“…In keeping with the findings of this study, the relevance of the art of “relational inquiry” (Doane & Varcoe, 2008) and mutual conscious attention to connecting “at the hyphen” (Buber, 1958) throughout care has been explicated by others (McWilliam, 2009). However, the empirical and theoretical literature also illuminates how paid provider-client connectedness may be constrained by traditional health care practice that creates and maintains relational boundaries with clients (Gantert et al, 2009), a process known as professional “distancing” and “othering” (Boreus, 2006).…”

How do community pharmacists conceptualise and operationalise self-care support of long-term conditions (LTCs)? An English cross-sectional survey

“…The theory and practice of patient‐centredness in the healthcare professional‐patient consultation has been strongly promoted by research and policy if the principles of self‐care support in the management of LTCs is to be adopted in practice . Paternalism which used to be the dominant model of consultation between healthcare professionals and patients is now viewed as detrimental to improving self‐care and overall patient health . Active and empowering partnerships between healthcare professionals and patients are a pre‐requisite for patient‐centred and quality healthcare .…”

The Meaning of a Positive Client-Nurse Relationship for Senior Home Care Clients with Chronic Disease

“…The findings of this study also afford insights into the meaning of a positive client-nurse relationship as being connected , illuminated in greater depth as feeling a personal interest , connecting as friends , and feeling like a person, not a patient. This insight is congruent with previous research (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; McWilliam, 2009; McWilliam et al, 1997; Miner-Williams, 2007; Nolan et al, 2003; Schoot et al, 2005) related to connectedness in the client-nurse relationship. More specifically, several authors (Gantert et al, 2008; Halldorsdottir, 2008; McGarry, 2008; Nolan et al, 2003; Schoot et al, 2005) have found that clients expect to be recognized and valued as a person of worth within this relationship and wish to be understood as an individual human being, apart from their illness.…”

Social-Interaction Knowledge Translation for In-Home Management of Urinary Incontinence and Chronic Care

“…In keeping with the findings of this study, the relevance of the art of “relational inquiry” (Doane & Varcoe, 2008) and mutual conscious attention to connecting “at the hyphen” (Buber, 1958) throughout care has been explicated by others (McWilliam, 2009). However, the empirical and theoretical literature also illuminates how paid provider-client connectedness may be constrained by traditional health care practice that creates and maintains relational boundaries with clients (Gantert et al, 2009), a process known as professional “distancing” and “othering” (Boreus, 2006).…”

How do community pharmacists conceptualise and operationalise self-care support of long-term conditions (LTCs)? An English cross-sectional survey

“…The theory and practice of patient‐centredness in the healthcare professional‐patient consultation has been strongly promoted by research and policy if the principles of self‐care support in the management of LTCs is to be adopted in practice . Paternalism which used to be the dominant model of consultation between healthcare professionals and patients is now viewed as detrimental to improving self‐care and overall patient health . Active and empowering partnerships between healthcare professionals and patients are a pre‐requisite for patient‐centred and quality healthcare .…”