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Appropriating and asserting power on inflammatory arthritis teams: A social network perspective
- Source :
- Health Expectations, Vol 23, Iss 4, Pp 813-824 (2020), Health Expectations : An International Journal of Public Participation in Health Care and Health Policy
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- Background Therapeutic interventions for people with inflammatory arthritis (IA) increasingly involve multidisciplinary teams and strive to foster patient-centred care and shared decision making. Participation in health-care decisions requires patients to assert themselves and negotiate power in encounters with clinicians; however, clinical contexts often afford less authority for patients than clinicians. This disadvantage may inhibit patients' involvement in their own health care. Objective To identify communication attributes, IA patients use to influence and negotiate their treatment with members of their health-care network. Method A qualitative social network approach was used to analyse data from a larger study that investigated IA patients' overall experiences of multidisciplinary care. Fourteen patients with IA attended individual semi-structured interviews. Researchers used thematic analysis to identify patterns of assertiveness and influence in the data. Results Participants experienced loss of identity, control and agency in addition to the physical symptoms of IA. However, they had a sense of personal responsibility for managing their health care. Perceptions of health-care team support enhanced patients' influence in treatment negotiations. Notably, there appeared to be an underlying tension between being empowered or disempowered. Discussion and conclusions The findings have significant implications for treatment decision communication approaches to IA care. A social network perspective may provide a pathway for clinicians to better understand the complexities of communication with their patients. This approach may reduce unequal power dynamics that occur within clinician/patient interactions and afford people with IA agency, control and affirmation of identity within their health-care network.
- Subjects :
- media_common.quotation_subject
Psychological intervention
Social Networking
power
03 medical and health sciences
0302 clinical medicine
Nursing
Multidisciplinary approach
treatment decisions
Agency (sociology)
Health care
Humans
Assertiveness
030212 general & internal medicine
Disadvantage
Qualitative Research
identity
inflammatory arthritis
media_common
lcsh:R5-920
Social network
business.industry
030503 health policy & services
Arthritis
Communication
lcsh:Public aspects of medicine
Public Health, Environmental and Occupational Health
lcsh:RA1-1270
illness stories
Original Research Paper
agency
Thematic analysis
Patient Participation
0305 other medical science
business
Psychology
lcsh:Medicine (General)
Decision Making, Shared
Original Research Papers
control
Subjects
Details
- Language :
- English
- ISSN :
- 13696513 and 13697625
- Volume :
- 23
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Health Expectations
- Accession number :
- edsair.doi.dedup.....e92226020796f0b3aa1cb62ad1fd60f3