Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Patient Educ Couns. 2010 Oct;81(1):94-100. doi: 10.1016/j.pec.2009.12.007. Epub 2010 Jan 13.
To explore how responsibility attribution influences self-management regimens among people with chronic illness.
This qualitative content analysis included 26 interviews with people living with chronic illness.
The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes.
How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility.
Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.
探讨责任归因如何影响慢性病患者的自我管理方案。
本定性内容分析包括对 26 名慢性病患者的访谈。
参与者将责任归因于内部、外部或两者的组合因素，这意味着他们要么对自我管理负责，要么认为其他人或因素负责。内部责任与多方面的自我管理方案有关，而外部责任与“常规”自我管理如服药、管理症状和生活方式改变有关。
责任归因的方式对于个人进行自我管理的方式至关重要。在这项研究中，那些将责任归因于外部因素的人主要是为了控制自己的疾病而执行推荐的行为。相比之下，要承担自己的责任并成为护理的积极参与者，个人必须对自己负责，即内部责任。
医疗保健提供者应该承认和支持个人对不同层次的责任以及不同类型的医患关系的愿望。
