Control in chronic condition self-care management: how it occurs in the health worker–client relationship and implications for client empowerment

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dc.contributor.author Lawn, Sharon Joy
dc.contributor.author Delany, Toni
dc.contributor.author Battersby, Malcolm Wayne
dc.contributor.author Skinner, Timothy
dc.date.accessioned 2014-07-09T00:16:14Z
dc.date.available 2014-07-09T00:16:14Z
dc.date.issued 2014-02
dc.description This item is under embargo for a period of 12 months from the date of publication, in accordance with the publisher's policy. en
dc.description.abstract Aim. To examine health worker–client interactions during care planning to understand processes that foster client empowerment and disempowerment. Background. It is unclear how health worker–client exchanges and information sharing through chronic condition care planning currently operate in primary health care. Moreover, it is unclear how control in these exchanges either enhances collaborative decision-making, partnership and client empowerment, or works to create client disempowerment and dependency on workers and health services. Design. Critical discourse analysis of qualitative data from ethnographic observations and audio-taped worker–client consultations. Method. Multidisciplinary teams in two Australian community-based primary healthcare sites participated. This included nurses, general practitioners and allied health workers and their clients who had a chronic condition care plan. Nineteen worker–client consultations were observed/recorded in 2011. Results. Control was expressed through multiple processes inherent in the worker role and in their interactions with clients. When workers exercised disproportionate control and clients relinquished their own control, client disempowerment and dependency were evident. Clients’ attempts to gain control and workers’ attempts to relinquish control alleviated clients’ disempowerment and dependency. However, structural features of information sharing systems and workers’ care planning behaviours diminished such efforts. Conclusion. Worker awareness of their communication style and the power of their role must improve for client chronic condition self-care management to be achieved. Training on the impacts of control in worker communication and systems where they work must be provided if unbeneficial forms of client dependency are to be overcome and true self-care management is to be realized. en
dc.identifier.citation Lawn, S.J., Delany, T., Sweet, L., Battersby, M. and Skinner, T. (2014). Control in chronic condition self-care management: How it occurs in the health worker-client relationship, and implications for client empowerment. Journal of Advanced Nursing, 70(2) pp. 383-394. en
dc.identifier.doi https://doi.org/10.1111/jan.12203 en
dc.identifier.issn 0309-2402
dc.identifier.uri http://hdl.handle.net/2328/27774
dc.language.iso en
dc.oaire.license.condition.license In Copyright
dc.publisher John Wiley & Sons, Ltd en
dc.rights © 2013 John Wiley & Sons Ltd en
dc.rights.holder John Wiley & Sons Ltd en
dc.title Control in chronic condition self-care management: how it occurs in the health worker–client relationship and implications for client empowerment en
dc.type Article en
local.contributor.authorOrcidLookup Lawn, Sharon Joy: https://orcid.org/0000-0002-5464-8887 en_US
local.contributor.authorOrcidLookup Battersby, Malcolm Wayne: https://orcid.org/0000-0001-7306-5591 en_US
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