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

Wilson, Patricia M., Kendall, Sally, Brooks, F. (2005) Nurses' responses to expert patients: The rhetoric and reality of self­-management in long­-term conditions: A grounded theory study. International Journal of Nursing Studies, 43 (7). pp. 803-808. ISSN 0020-7489. E-ISSN 1873-491X. (doi:10.1016/j.ijnurstu.2005.10.011) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1016/j.ijnurstu.2005.10.011

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: ? Explore how patient expertise is viewed, interpreted, defined and experienced by both patients and health professionals. ? Analyse how patient expertise is promoted and enabled through the self-management process. ? Uncover the mechanisms that enhance or impede the development of patient expertise. 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 selfmanagement. 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.

Item Type: Article
DOI/Identification number: 10.1016/j.ijnurstu.2005.10.011
Uncontrolled keywords: Chronic disease; Expert patient; Nurse’s role; Patient participation; Self-care
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RT Nursing
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 03 May 2016 14:50 UTC
Last Modified: 29 May 2019 17:17 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/55210 (The current URI for this page, for reference purposes)
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