Independence/dependence--a contradictory relationship? Life with a chronic illness

Scand J Caring Sci. 2006 Sep;20(3):261-8. doi: 10.1111/j.1471-6712.2006.00403.x.

Abstract

This study shows that self-responsibility and self-control are meaningful values in the activities and decisions of everyday life. Dignity and being respected as an individual are closely connected to being able to manage on one's own and being independent of others' help. The study also shows that including other people into one's life situation can be an important sign of self-management. However, the critical interpretation shows that it is the view of the human being which determines whether help from others and self-managing on one's own can be combined. With a relational view of the human being, i.e. the basic condition that people always enter into relations of dependence, there is no contradiction between independence and dependence. In contrast, an individualist, liberalist view of the human being promotes an attitude of blaming oneself with the potential for feelings of inadequacy and guilt. The study also shows that seeking out treatment in the alternative medical sector maintain a form of continued self-control and self-responsibility. The study concludes that the nurse must work to qualify her/his sensory-based, situationally determined attentiveness and her/his view of the human being, which will include directing her/his attention towards the patient's view of the human being, values and ways of relating to oneself and to one's choices. The research design is qualitative and takes a phenomenological-hermeneutic approach. The data are based on interviews with 18 chronically ill patients, divided into three groups of six patients diagnosed with 'type I' diabetes, colitis ulcerosa and patients with coronary occlusion in the rehabilitation phase. Regardless of the diagnosis, the objective of the interview study was to highlight themes in the patients' views of health and illness related to their chronic condition and the significance of these views have for their mastery of everyday life. The research method is inspired by Paul Ricoeur.

MeSH terms

  • Activities of Daily Living / psychology*
  • Adaptation, Psychological
  • Adult
  • Attitude to Health*
  • Chronic Disease / nursing
  • Chronic Disease / psychology*
  • Colitis, Ulcerative / psychology
  • Coronary Disease / psychology
  • Diabetes Mellitus, Type 1 / psychology
  • Existentialism / psychology
  • Female
  • Humanism
  • Humans
  • Individuality
  • Internal-External Control*
  • Life Change Events
  • Male
  • Middle Aged
  • Nurse's Role / psychology
  • Nursing Methodology Research
  • Personal Autonomy*
  • Qualitative Research
  • Self Care / psychology
  • Self Concept
  • Sick Role
  • Surveys and Questionnaires