Patient expertise: Contested territory in the realm of long-term condition care
journal contributionposted on 2023-02-22, 22:47 authored by Helen Francis, Jenny Carryer, Jillian WilkinsonJillian Wilkinson
Objectives The aim of this study was to describe the experience of people with multiple long-term conditions with particular reference to the notion of the ‘expert patient’ in the context of self-management. Methods A multiple case study of 16 people with several long-term conditions, included interviews and contacts over an 18-month period and an interview with their primary care clinicians. Analysis included both case-by-case and some cross-case analysis. Results The findings reveal the patient participants had little capacity to exercise the agency necessary be an expert patient as premised. Weariness, shame, expertise, issues of compliance and control and collaboration are contested areas underpinning clinician encounters. Discussion Patient expertise is at the heart of self-management approaches but the findings surfaced several inherent contradictions between the idealised expert patient and their position within a health care system that is entrenched in biomedicine. Conclusion There is a mismatch between how the self-management approach has been operationalised and what the participants who have multiple LTCs reveal as what they want and need. The research concludes that the self-management approach is inappropriate for people with multiple LTCs and that other ways of offering care should be considered.
Preferred citationFrancis, H., Carryer, J. & Wilkinson, J. (2019). Patient expertise: Contested territory in the realm of long-term condition care. Chronic Illness, 15(3), 197-209. https://doi.org/10.1177/1742395318757853
Journal titleChronic Illness
Online publication date2018-02-22
Long-term conditionschronic illnessself-managementexpert patientbiomedicineAgedAged, 80 and overChronic DiseaseComorbidityFemaleHumansInterviews as TopicLong-Term CareMaleMiddle AgedPatient SatisfactionPhysicians, Primary CareQualitative ResearchClinical Research7.1 Individual care needs7 Management of diseases and conditions7.3 Management and decision makingPublic HealthPublic Health and Health Services not elsewhere classifiedClinical Sciences not elsewhere classified