Moving between ideologies in self-management support-A qualitative study

Dagmara Bossy; Ingrid Ruud Knutsen; Anne Rogers; Christina Foss

doi:10.1111/hex.12833

Moving between ideologies in self-management support-A qualitative study

Health Expect. 2019 Feb;22(1):83-92. doi: 10.1111/hex.12833. Epub 2018 Oct 5.

Authors

Dagmara Bossy^{1

2}, Ingrid Ruud Knutsen^{2

3}, Anne Rogers⁴, Christina Foss²

Affiliations

¹ Norwegian National Advisory Unit on Learning and Mastery in Health, Universitetssykehus HF, Aker Sykehus, Oslo, Norway.
² Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.
³ Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Kjeller, Norway.
⁴ NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Hampshire, UK.

Abstract

Background: Reforms in current health policy explicitly endorse health promotion through group-based self-management support for people with long-term conditions. Health promotion and traditional medicine are based on different logics. Accordingly, health professionals in health-promoting settings demand the adoption of new practices and ways of thinking.

Objectives: The objective of our study was to investigate how health professionals perceive the health-promoting group-based self-management support that is politically initiated for people with long-term conditions.

Design: This study had a qualitative research design that included focus group interviews and was guided by a social constructivist paradigm in which group-based self-management was viewed as a social construction. Different logics at play were analysed through the theoretical lens of institutional logic. Discussions among participants show frames of references seen as logics.

Setting and participants: We recruited health professionals from group-based health-promoting measures for people with type 2 diabetes in Norway. Two focus groups comprising four and six participants each were invited to discuss the practices and value of health promotion through group-based self-management support.

Results: The analysis resulted in three themes of discussion among participants that contained reflections of logics in movement. Health professionals' discussions moved between different logics based on the importance of expert-based knowledge on compliance and on individual lifestyle choices.

Discussion and conclusion: The study indicates that health promotion through self-management support is still a field "in the making" and that professionals strive to establish new logics and practices that are not considered difficult to manage or do not contain incompatible understandings.

Keywords: health policy implementation; health professionals; health promotion; institutional logic; self-management support; type 2 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2 / therapy
Health Education
Health Policy
Health Promotion*
Humans
Qualitative Research*
Self Care
Self-Help Groups
Self-Management*

Abstract

Publication types

MeSH terms

Grants and funding