Marika Franklin1, Sophie Lewis2, Karen Willis3, Anne Rogers4, Annie Venville5, Lorraine Smith6. 1. College of Science, Health and Engineering, La Trobe University, Australia. Electronic address: marika.franklin@ltu.edu.au. 2. Faculty of Arts and Social Sciences, University of New South Wales, Australia. 3. College of Science, Health and Engineering, La Trobe University, Australia; Allied Health Research, Royal Hospital of Melbourne, Australia. 4. Faculty of Health Sciences, University of Southampton, United Kingdom. 5. College of Health and Biomedicine, Victoria University, Australia. 6. Faculty of Pharmacy, University of Sydney, Australia.
Abstract
INTRODUCTION: Premised on the idea that setting goals motivates action and allocation of resources toward a desired future state, goal-setting has become a key component of self-management support. The notions that underpin goal-setting situate self-management firmly within the control and responsibility of individuals. Yet, we argue that goals are not solely individual pursuits to be achieved if individuals have the right knowledge and enough motivation; rather, they are social products, influenced by individual and collective subjectivities, which are structured over time. OBJECTIVE: Drawing primarily on Bourdieu's concept of habitus, along with capital and field, we examine how goals are constructed in self-management support encounters. METHOD: Seventeen patient-professional dyads comprising 15 patients and 11 health professionals were interviewed on up to three occasions. In total 64 semi-structured interviews were conducted between 2015 and 2017 in Sydney, Australia. RESULTS: Goals were manifested through patient participants' expressions of goal agency (as self-owned wants and opportunities; responsibilities to self and others; or necessities); goal-oriented dispositions (determined; responsible; or powerless); temporal orientations (past, present or future); and access to resources to support self-management. These characteristics were grouped into three typologies: 'Goals as opportunities'; 'From goals to responsibilities'; and 'Necessities when living precariously'. CONCLUSIONS: The way goals were constructed was structured over time by present experiences superimposed on past experiences and access to resources. These findings help broaden understandings of the tensions between patient and professionals' goals for living well with chronic conditions and draw attention to the need for structural change to support people to live well with their chronic conditions.
INTRODUCTION: Premised on the idea that setting goals motivates action and allocation of resources toward a desired future state, goal-setting has become a key component of self-management support. The notions that underpin goal-setting situate self-management firmly within the control and responsibility of individuals. Yet, we argue that goals are not solely individual pursuits to be achieved if individuals have the right knowledge and enough motivation; rather, they are social products, influenced by individual and collective subjectivities, which are structured over time. OBJECTIVE: Drawing primarily on Bourdieu's concept of habitus, along with capital and field, we examine how goals are constructed in self-management support encounters. METHOD: Seventeen patient-professional dyads comprising 15 patients and 11 health professionals were interviewed on up to three occasions. In total 64 semi-structured interviews were conducted between 2015 and 2017 in Sydney, Australia. RESULTS: Goals were manifested through patientparticipants' expressions of goal agency (as self-owned wants and opportunities; responsibilities to self and others; or necessities); goal-oriented dispositions (determined; responsible; or powerless); temporal orientations (past, present or future); and access to resources to support self-management. These characteristics were grouped into three typologies: 'Goals as opportunities'; 'From goals to responsibilities'; and 'Necessities when living precariously'. CONCLUSIONS: The way goals were constructed was structured over time by present experiences superimposed on past experiences and access to resources. These findings help broaden understandings of the tensions between patient and professionals' goals for living well with chronic conditions and draw attention to the need for structural change to support people to live well with their chronic conditions.
Authors: Jamie Murdoch; Charlotte Salter; John Ford; Elizabeth Lenaghan; Alice Shiner; Nicholas Steel Journal: Soc Sci Med Date: 2020-05-15 Impact factor: 4.634