Nurses' responses to expert patients: the rhetoric and reality of self-management in long-term conditions: a grounded theory study.

Abstract:

BACKGROUND:Against the backdrop in the western world of increasing prevalence of chronic disease, active and informed patients and a policy emphasis on self-management, this English study explored health professionals' responses to expert patients. OBJECTIVES:To: DESIGN:A grounded theory approach was utilised with two concurrent data strands. SETTING:A relatively affluent English county including community, primary and secondary care settings. PARTICIPANTS:Via purposeful and theoretical sampling 100 health professionals (nurses, doctors, physiotherapists) and 100 adults affected by chronic disease participated. METHODS:Focus groups, interviews and observation. RESULTS:Nurses were found to be most anxious about expert patients when compared to other professionals, which appeared to be linked with a lack of professional confidence and unfounded fears regarding litigation. However, nurse specialists often provided a negative case for this. As a whole, nurses were most able to meet the emotional needs of patients, but apart from nurse specialists did not articulate this as a skill. CONCLUSION:Apart from nurse specialists the majority of nurses appeared limited in appropriately facilitating self-management. It is suggested that this is linked to an ongoing nursing culture of patient as passive, an over-emphasis on empirical knowledge and a feeling of vulnerability on the nurses' part towards expert patients. The findings also indicate a rhetoric rather than reality of autonomous nursing roles within the chronic disease management agenda.

journal_name

Int J Nurs Stud

authors

Wilson PM,Kendall S,Brooks F

doi

10.1016/j.ijnurstu.2005.10.011

keywords:

subject

Has Abstract

pub_date

2006-09-01 00:00:00

pages

803-18

issue

7

eissn

0020-7489

issn

1873-491X

pii

S0020-7489(05)00203-8

journal_volume

43

pub_type

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