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.