• Nursing inquiry · Jul 2019

    Reconsidering the 'self' in self-management of chronic illness: Lessons from relational autonomy.

    • Lydia Ould Brahim.
    • Ingram School of Nursing, McGill University, Montreal, Quebec, Canada.
    • Nurs Inq. 2019 Jul 1; 26 (3): e12292.

    AbstractSelf-management is often presented as a panacea for chronic disease care. It plays an important role at the policy level and increasingly guides the delivery of health care services. Self-management approaches to care are founded on traditional individualistic views of autonomy in which the patient is understood as being independent, rational, self-interested, and self-governing. This conceptualization of autonomy has been challenged, particularly by feminist scholars. In this paper I review predominant critiques of self-management and the traditional individualistic view of autonomy. I propose that a relational approach to autonomy, which is premised on social embeddedness and attends to social, political, and material conditions, is a more sound conception of autonomy capable of taking into consideration the complexities of illness experiences. I suggest that integrating a relational perspective of autonomy into self-management will be valuable in guiding its progression and elaborate ways in which self-management research and practice could benefit from incorporating a relational approach to autonomy.© 2019 John Wiley & Sons Ltd.

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