| Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. | |
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MedLine Citation:
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PMID: 20819914 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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OBJECTIVES: to analyse the narratives of people with diabetes to inform the design of culturally congruent self-management education programmes. METHODS: the study was based on quasi-naturalistic story-gathering; i.e. making real-time field notes of stories shared spontaneously in diabetes self-management education groups in a socioeconomically deprived London borough. Eighty-two adults aged 25-86, from six minority ethnic groups who were in the intervention arm of a randomized controlled trial of story-sharing, participated. Stories were translated in real time by the facilitator or group members. Ethnographic field notes were transcribed, and analysed thematically (to identify self-management domains raised by participants) and interpretively for over-arching storylines (i.e. considering how self-management domains were contextualized and made meaningful in personal narratives). Analysis was informed by both biomedical and sociological theories of self-management. RESULTS: people with diabetes identified seven self-management domains: knowledge; diet; exercise; medication; foot care; self-monitoring; and attending check-ups. Interpretive analysis revealed eight illness storylines within which these practical issues acquired social meaning and moral worth: becoming sick; rebuilding spoiled identity; becoming a practitioner of self-management; living a disciplined and balanced life; mobilizing a care network; navigating and negotiating in the health care system; managing the micro-morality of self-management 'choices'; and taking collective action. CONCLUSION: living with diabetes involves both medically recommended behaviours and complex biographical work to make sense of and cope with illness. Self-management education programmes should take closer account of over-arching storylines that pattern experience of chronic illness and recognize that some elements of self-management knowledge cannot be pre-specified in a structured curriculum. |
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Authors:
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Trisha Greenhalgh; Anna Collard; Desirée Campbell-Richards; Shanti Vijayaraghavan; Farida Malik; Joanne Morris; Anne Claydon |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-09-06 |
Journal Detail:
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Title: Journal of health services research & policy Volume: 16 ISSN: 1758-1060 ISO Abbreviation: J Health Serv Res Policy Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9604936 Medline TA: J Health Serv Res Policy Country: England |
Other Details:
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Languages: eng Pagination: 37-43 Citation Subset: H |
Copyright Information:
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The Royal Society of Medicine Press Ltd 2011. |
Affiliation:
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Queen Mary University of London, London. p.greenhalgh@ucl.ac.uk |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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