The influence of illness perspectives on self-management of chronic disease

Abstract

audulv å, asplund k & norbergh k‐g (2011) Journal of Nursing and Healthcare of Chronic Illness3, 109–118 The influence of illness perspectives on self‐management of chronic disease Aim. To explore people’s illness perspectives and related self‐management of chronic disease. Background. Individuals’ illness beliefs and perspectives have been suggested to influence their self‐management behaviour. However, research that has examined the influence of illness perspectives on chronic disease self‐management has been largely quantitative and has focused on selected elements of self‐management. How individuals’ illness perspectives influence their whole of self‐management has not been investigated in depth. Method. The phenomenographic research study entailed 26 narrative interviews with Swedish adults with a variety of chronic diseases. Data were collected mostly during 2006. Results. The participants described two illness perspectives; being life‐oriented meant to focus upon how to live a good life with disease, whereas a disease‐oriented illness perspective emphasised the medical and physiological aspects of disease. The participants attested to one of the two illness perspectives as a main perspective, although they shifted between the perspectives depending of context and illness experience. The participants’ illness perspectives were reflected in their understandings of self‐management. Participants with a dominant life‐oriented illness perspective performed self‐management in order to continue living a ‘normal’ life (e.g. facilitate activity and mental well‐being). When holding a disease‐oriented illness perspective, self‐management was focused upon controlling disease (e.g. symptom management and avoiding disease related complications). Conclusions. People with chronic illness hold a dominant illness perspective that determines how they understand and enact self‐management. These perspectives are not static; instead individuals tend to shift between the perspectives under specific circumstances. Relevance to clinical practice. Health‐care providers shall acknowledge that individuals’ with chronic illness shift between a life‐oriented and a disease‐oriented illness perspective. The results of the current study can be used by health‐care providers in order to launch a dialogue in order to support individuals’ self‐management.

An Exploration Into Knowledge, Attitudes, and Beliefs Towards Risky Health Behaviours in a Paediatric Cystic Fibrosis Population

“…10–12 Evidence of a life-orientated illness perspective is also prevalent, with some participants reporting that they believe individuals engage in risky behaviours for fun. 14…”

“…8,13 Such individual perceptions hold a life-orientated illness perspective, with their engagement in such behaviours being for fun and enjoyment. 14 This is found within multiple chronic diseases, with individuals who hold a life-orientated illness perspective often focusing on their well-being, viewing their chronic disease as only part of their daily lives. 14…”

“…14 This is found within multiple chronic diseases, with individuals who hold a life-orientated illness perspective often focusing on their well-being, viewing their chronic disease as only part of their daily lives. 14…”

Is Australian primary care practice equipped to provide multimorbidity care?

“…The physiological symptoms and impact of disease generally affects people in similar ways, but the experience of illness, including the behaviours, attitudes, and beliefs that emerge as a result of the experience may differ substantially across individuals, populations and cultures (64,(149)(150)(151). A person's illness experience will inform the decisions they make regarding their health and health care (64,132,(152)(153)(154). Individuals will respond, assign meaning, or make sense of their illness, within the context of an "illness narrative": a term Kleinman coined in 1988 (155) to describe the individual's story of illness.…”

“…and construct responses (64,132,(152)(153)(154). From a clinical perspective, emphasis is placed on diagnosing and treating disease (64,65).…”