Understanding the disconnect between lifestyle advice and patient engagement: a discourse analysis of how expert knowledge is constructed by patients with CHD.
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引用次数: 0
Abstract
Objective: Adherence to healthy lifestyle advice is effective in prevention of non-communicable diseases like coronary heart disease (CHD). Yet patient disengagement is the norm. We take a novel discursive approach to explore patients' negotiation of lifestyle advice and behaviour change.
Method: A discourse analysis was performed on 35 longitudinal interviews with 22 heterosexual British people in a long-term relationship, where one had a diagnosis of CHD. The analysis examined the relationships between patients' constructions of expert knowledge and the implications of these accounts for patients' dis/engagement with lifestyle advice.
Results: Expert knowledge was constructed in four ways: (1) Expert advice was valued, but adherence created new risks that undermined it; (2) expert knowledge was problematised as multiple, contradictory, and contested and therefore difficult to follow; (3) expert advice was problematised as too generalised to meet patients' specific needs; and (4) expert advice was understood as limited and only one form of valued knowledge.
Conclusion: Patients and partners simultaneously valued and problematised expert knowledge, drawing on elaborate lay epistemologies relating to their illness which produced complex patterns of (dis)engagement with expert lifestyle advice. Recognition of the multiple and fluid forms of knowledge mobilised by CHD patients could inform more effective interventions.
期刊介绍：
Psychology & Health promotes the study and application of psychological approaches to health and illness. The contents include work on psychological aspects of physical illness, treatment processes and recovery; psychosocial factors in the aetiology of physical illnesses; health attitudes and behaviour, including prevention; the individual-health care system interface particularly communication and psychologically-based interventions. The journal publishes original research, and accepts not only papers describing rigorous empirical work, including meta-analyses, but also those outlining new psychological approaches and interventions in health-related fields.
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