The Structure of Everyday Self-Care Decision Making in Chronic Illness

Abstract

As health care reform strategists increasingly recognize the critically important potential of effective everyday self-care decision making for reducing the burden of illness and the strain on health service systems, we must find ways to understand and support it. In this study, the authors investigate persons with expertise in self-care management of type 2 diabetes, HIV/AIDS, and multiple sclerosis to understand how everyday self-care decision making is learned and experienced. They used interview, think-aloud, and focus groups to construct an account of how persons affected by these chronic diseases make decisions in relation to the choices in their everyday lives and learn to manage the untoward effects of these conditions according to their unique contexts and values. The findings form a conceptual foundation for ongoing inquiry into this complex phenomenon and provide insights that might assist clinicians to understand more fully the responses and attitudes of those they serve.

Evidence produced by qualitative investigations on type 2 diabetes: a review of the literature

“…Explorando o conceito de reconstrução narrativa (Williams, 2002) e o de trajetória, alguns estudos (Lawton, Peel, Parry, 2008;Garcia et al, 2007;Naemiratch, Manderson, 2006;Thorne, Paterson, Russell, 2003) mostram como o cuidado é ressignificado ao longo do processo de adoecimento e do itinerário terapêutico, sem que se possam identificar relações aprioristicamente determinadas entre concepções etiológicas, reações ao diagnóstico e organização do cuidado. Ao colocar a experiência de adoecimento e de cuidado em uma perspectiva temporal, esses estudos mostram a relevância de se compreender a trajetória de pessoas que convivem com e a partir do diabetes.…”

Raising hypertensive patients' consciousness about treatment compliance

“…Thus, in the beginning, they try to follow it strictly. They try to change their eating habits, get used to exercising, (12)(13)(14)(15) . Patients adapt the treatment to their social habits, and when it conflicts with their individual welfare, they allow for certain indulgences in order to minimize the impact of these strict standards and rules.…”

“…To control means being able to mediate the effects of the disease, so that one can live as normal as possible (14) .…”

Developing Educational Materials to Facilitate Adherence: Pediatric Thrombosis as a Case Illustration

“…Adherence is universally recognized as a critical and contentious issue in the management of both acute and chronic illness in children (Becker et al, 1979;Horne & Weinman, 1999;Paterson, Thorne, & Russell, 2002;Thorne, 1993;Thorne et al, 2002;Thorne, Paterson, & Russell, 2003). Among definitions of adherence, the common elements refer to the extent to which the patient acts consistently and in accordance with medical recommendations (Becker et al;Brenner et al, 2004;Cassileth, Zupkis, Sutton-Smith, & March, 1980;Makoul, Arntson, & Schofield, 1995).…”

“…Solving the problems related to each of these factors is necessary if patients' adherence to therapies is to be improved. There is no single intervention strategy or combination of strategies that has been shown to be effective across all patients, conditions, and settings (Sabaté;Thorne, Paterson, & Russell, 2003). Consequently, interventions that focus on adherence must be tailored to the particular illness-related demands experienced by the patient.…”