Dialogue for Air, Air for Dialogue: Towards Shared Responsibilities in COPD Practice

Abstract

For the past several years patients have been expected to play a key role in their recovery. Self management and disease management have reached a hype status. Considering these recent trends what does this mean for the division of responsibilities between doctors and patients? What kind of role should healthcare providers play? With findings based on a qualitative research project of an innovative practice for people with Chronic Obstructive Pulmonary Disease (COPD) we reflect on these questions. In-depth interviews conducted with people with COPD, physiotherapists and a pulmonologist show that shifting responsibilities require a supportive attitude from healthcare providers and a dialogical communication between patients and professionals. Our findings show more is needed in order to motivate people with COPD to take responsibility and become co-owners in a process of recovery. The case example illustrates that people with COPD need support from fellow patients to learn to accept their disabilities. Awareness that COPD is more than just a lack of air, that mind and body interact, is a first step to investigate other potential problems and to enhance one's quality of life.

The development and psychometric validation of the self‐efficacy and performance in self‐management support (SEPSS) Instrument

“…, Lorig & Holman , Visse et al . ), shared decision‐making, collaborative goal setting (Lorig & Holman , Stacey et al . , Kriston et al .…”

How shared is shared decision-making? A care-ethical view on the role of partner and family

“…However, research shows that SDM is a practice full of tensions. The ideal and the practice are often wide apart, the practice is often complex and participants experience it very differently 1 2. In this complex practice, the ‘third party’ of the partner and the family may be experienced as an extra complicating factor,6–9 even if their participation and contribution are welcome in principal 10 11.…”

“…Although shared decision-making (SDM) is not yet a common practice in health or palliative care, empirical research shows that patient groups benefit from SDM 1 2. Including the patient as a participant in the decision-making process is vital for good care, on legal grounds and from a care-ethical perspective 1 2.…”

“…Including the patient as a participant in the decision-making process is vital for good care, on legal grounds and from a care-ethical perspective 1 2. For patients are legally entitled to decide about their lives and bodies, but since care ethics views care as a relational practice, a decision about good care for a particular patient can only come about in a relational attuning process.…”

Moral Learning in an Integrated Social and Healthcare Service Network

“…However, we believe that in the future, more clients will be expected to become part of integrated services. In the Netherlands, for example, self-management and a more prominent role for clients in their own cases, is being promoted [31]. In the future, we expect that the client's identity will go beyond someone or some group (e.g., family) that needs support.…”