Uncovering the Limits of Patient-Centeredness: Implementing a Self-Management Trial for Chronic Illness
Abstract
Research evaluating self-management of chronic conditions points to the effectiveness of interventions’ changing the health behavior of individuals. However, we know little about how self-management is negotiated within health services. The authors designed a qualitative investigation to illuminate the quantitative findings of a randomized controlled trial (RCT) of a self-management program for people with inflammatory bowel disease. They conducted in-depth interviews with physicians and patients, and qualitative analysis illuminated the nature of doctor-patient encounters and possible reasons for lack of change in patient satisfaction with the consultation. The findings suggest that factors inhibiting effective patient-centered consultations include failure of physicians to incorporate expressed need relevant to people’s self-management activities fully, interpretation of selfmanagement as compliance with medical instructions, and the organization of outpatients’ clinics. Giving attention to these barriers might maximize the opportunities for patient selfmanagement of chronic illness based on a therapeutic alliance with health care professionals.
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Deep rooted communication issues such as differential mental health models, perceived candidacy for treatment and recursivity in cultural expectations of treatment exist in both groups.
“A marked difference between groups included meeting the language needs of some minority patients, however deep rooted communication issues such as differential mental health models [21], perceived candidacy for treatment [22] and recursivity in cultural expectations of treatment [23] exist in both groups [8].”
From Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care (2014) · cites this paper as [23]
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“A marked difference between groups included meeting the language needs of some minority patients, however deep rooted communication issues such as differential mental health models [21], perceived candidacy for treatment [22] and recursivity in cultural expectations of treatment [23] exist in both groups [8].”
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- Authors
- Rogers, A., Kennedy, A., Nelson, E., & Robinson, A.
- Affiliations
- University of Manchester (GB)
- Salford Royal Hospital (GB)
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2005-02
- Volume
- 15
- Issue
- 2
- Pages
- 224-239
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2111156635
- Cited by
- 162
- References
- 35
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 2 · 2022: 12 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 13 · 2014: 11 · 2013: 11 · 2012: 13
- FWCI
- 12.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- ResearchOnline (Glasgow Caledonian University) (acceptedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- patient-centered care, self-management, chronic disease, inflammatory bowel disease, doctor-patient encounters, therapeutic relationship, patient satisfaction, physician-patient communication, barriers to self-management, health behavior change
- MeSH terms
- Adult, Chronic Disease, Female, Humans, Interviews as Topic, Male, Middle Aged, Patient Education as Topic, Professional-Patient Relations, Self Care, Social Support, Inflammatory Bowel Diseases, Health Behavior, Patient-Centered Care, Qualitative Research
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