How do people with COPD or diabetes type 2 experience autonomy? An exploratory study

Abstract

Personal autonomy in the context of chronic physical illness might be conceptualized as correspondence between the way people's lives are actually arranged and the way people want their lives to be arranged, considering the circumstances. Health professionals could stimulate their clients to prevent and overcome impasses in the realisation of autonomy, while broad self-management interventions might improve people's skills for coping with the impact of chronic illness on autonomy.

How do informal self-care strategies evolve among patients with chronic obstructive pulmonary disease managed in primary care? A qualitative study

“…The presence of an illness that affects activities of daily living may lead to a reappraisal of important activities for patients, in which autonomy is preserved as expectations are reframed according to current circumstances 19. It seems plausible to suggest that if patients feel confident and empowered about what they are doing to cope with their illness, this will encourage further positive behavior and buffer against distress as a result of the changes made.…”

Utilization of health care by patients with multiple sclerosis is based on professional and patient-defined health needs

“…Most functional outcome measures focus on objective concepts, such as physical independence, rather than on self-perceived concepts, such as autonomy [3,4]. Moreover, the assessment of functional outcomes made by clinicians seems to differ from the assessment made by the patients themselves [5,6].…”

Understanding through experience: information, experience and understanding in clinical rehabilitation practice

“…Autonomy in chronic illness is described as a process in which patients actively modify their behaviors and expectations in interaction with the world around them, accommodating to the circumstances changed by illness and adapting those circumstances to one's own structure of meaning. Empirical studies have confirmed the importance of patients' personal experience for their autonomy in chronic illness such as stroke [32], diabetes [17], chronic obstructive pulmonary disease [30] and cervical spinal injury [18]. Being informed is mentioned as one contributing factor.…”

“…Studies of patient autonomy in chronic illness, rehabilitation, and long-term care normally apply broader conceptions of autonomy, seeing autonomy as a characteristic of persons, not only of decisions about consent [3,11,12,[30][31][32]. Patients' personal experience is more explicitly emphasized in these conceptions.…”