Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population.
OBJECTIVES: to analyse the narratives of people with diabetes to inform the design of culturally congruent self-management education programmes. METHODS: the study was based on quasi-naturalistic story-gathering; i.e. making real-time field notes of stories shared spontaneously in diabetes self-man...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2011
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| _version_ | 1797088037828558848 |
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| author | Greenhalgh, T Collard, A Campbell-Richards, D Vijayaraghavan, S Malik, F Morris, J Claydon, A |
| author_facet | Greenhalgh, T Collard, A Campbell-Richards, D Vijayaraghavan, S Malik, F Morris, J Claydon, A |
| author_sort | Greenhalgh, T |
| collection | OXFORD |
| description | OBJECTIVES: to analyse the narratives of people with diabetes to inform the design of culturally congruent self-management education programmes. METHODS: the study was based on quasi-naturalistic story-gathering; i.e. making real-time field notes of stories shared spontaneously in diabetes self-management education groups in a socioeconomically deprived London borough. Eighty-two adults aged 25-86, from six minority ethnic groups who were in the intervention arm of a randomized controlled trial of story-sharing, participated. Stories were translated in real time by the facilitator or group members. Ethnographic field notes were transcribed, and analysed thematically (to identify self-management domains raised by participants) and interpretively for over-arching storylines (i.e. considering how self-management domains were contextualized and made meaningful in personal narratives). Analysis was informed by both biomedical and sociological theories of self-management. RESULTS: people with diabetes identified seven self-management domains: knowledge; diet; exercise; medication; foot care; self-monitoring; and attending check-ups. Interpretive analysis revealed eight illness storylines within which these practical issues acquired social meaning and moral worth: becoming sick; rebuilding spoiled identity; becoming a practitioner of self-management; living a disciplined and balanced life; mobilizing a care network; navigating and negotiating in the health care system; managing the micro-morality of self-management 'choices'; and taking collective action. CONCLUSION: living with diabetes involves both medically recommended behaviours and complex biographical work to make sense of and cope with illness. Self-management education programmes should take closer account of over-arching storylines that pattern experience of chronic illness and recognize that some elements of self-management knowledge cannot be pre-specified in a structured curriculum. |
| first_indexed | 2024-03-07T02:44:11Z |
| format | Journal article |
| id | oxford-uuid:ab7bb2df-9823-45e1-b410-1358636c5568 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:44:11Z |
| publishDate | 2011 |
| record_format | dspace |
| spelling | oxford-uuid:ab7bb2df-9823-45e1-b410-1358636c55682022-03-27T03:22:10ZStorylines of self-management: narratives of people with diabetes from a multiethnic inner city population.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ab7bb2df-9823-45e1-b410-1358636c5568EnglishSymplectic Elements at Oxford2011Greenhalgh, TCollard, ACampbell-Richards, DVijayaraghavan, SMalik, FMorris, JClaydon, A OBJECTIVES: to analyse the narratives of people with diabetes to inform the design of culturally congruent self-management education programmes. METHODS: the study was based on quasi-naturalistic story-gathering; i.e. making real-time field notes of stories shared spontaneously in diabetes self-management education groups in a socioeconomically deprived London borough. Eighty-two adults aged 25-86, from six minority ethnic groups who were in the intervention arm of a randomized controlled trial of story-sharing, participated. Stories were translated in real time by the facilitator or group members. Ethnographic field notes were transcribed, and analysed thematically (to identify self-management domains raised by participants) and interpretively for over-arching storylines (i.e. considering how self-management domains were contextualized and made meaningful in personal narratives). Analysis was informed by both biomedical and sociological theories of self-management. RESULTS: people with diabetes identified seven self-management domains: knowledge; diet; exercise; medication; foot care; self-monitoring; and attending check-ups. Interpretive analysis revealed eight illness storylines within which these practical issues acquired social meaning and moral worth: becoming sick; rebuilding spoiled identity; becoming a practitioner of self-management; living a disciplined and balanced life; mobilizing a care network; navigating and negotiating in the health care system; managing the micro-morality of self-management 'choices'; and taking collective action. CONCLUSION: living with diabetes involves both medically recommended behaviours and complex biographical work to make sense of and cope with illness. Self-management education programmes should take closer account of over-arching storylines that pattern experience of chronic illness and recognize that some elements of self-management knowledge cannot be pre-specified in a structured curriculum. |
| spellingShingle | Greenhalgh, T Collard, A Campbell-Richards, D Vijayaraghavan, S Malik, F Morris, J Claydon, A Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title | Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title_full | Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title_fullStr | Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title_full_unstemmed | Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title_short | Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population. |
| title_sort | storylines of self management narratives of people with diabetes from a multiethnic inner city population |
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