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The Expert Patients Programme: a paradox of patient empowerment and medical dominance.

Wilson, Patricia M., Kendall, Sally, Brooks, Fiona (2007) The Expert Patients Programme: a paradox of patient empowerment and medical dominance. Health and Social Care in the Community, 15 (5). pp. 426-438. ISSN 1365-2524. E-ISSN 1365-2524. (doi:10.1111/j.1365-2524.2007.00701.x) (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/10.1111/j.1365-2524.2007.00701.x

Abstract

Self-care is seen as a key element in managing resource demand in chronic disease and is also perceived as an empowering right for patients. The Chronic Disease Self-Management Programme developed in the USA has been adopted in a number of countries and in the UK has been as adapted as the Expert Patients Programme. However, despite its potential as a lay-led empowering initiative, the Expert Patients Programme has been criticised as perpetuating the medical model and failing to reach those in most need. This paper revisits a critique of the Expert Patients Programme, and drawing upon a qualitative study seeks to explore whether the Expert Patients Programme enables empowerment or replicates traditional patterns of the patient–professional relationship. A grounded-theory approach was adopted utilising focus groups, in-depth interviews and participant observation. Data were analysed through the constant comparative method and the development of codes and categories. Conducted in the relatively affluent area of the south-east of England, this paper draws on data from 66 individuals with a chronic illness who were knowledgeable, active and informed. The study revealed a number of characteristics common to expert patients that were linked to a systematic, proactive and organised approach to self-management, a clear communication style and the ability to compartmentalise emotion. The study included participant observation of an Expert Patients Programme and a professional-led self-management course. The paradoxical nature of the Expert Patients Programme was revealed, for whilst there was evidence that it reinforced the medical paradigm, there was a concurrent acknowledgement and support for the subjective experience of living with a long-term condition. Furthermore, whilst the policy emphasis has been on individual empowerment within the Expert Patients Programme, there is some evidence that it may be triggering a health consumer movement.

Item Type: Article
DOI/Identification number: 10.1111/j.1365-2524.2007.00701.x
Uncontrolled keywords: chronic disease, expert patient, patient education, patient participation, self-care
Subjects: R Medicine > RA Public aspects of medicine
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 16:04 UTC
Last Modified: 29 May 2019 17:17 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/55212 (The current URI for this page, for reference purposes)
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