Dependence and identity: nurses and chronic conditions in a primary care setting

Dependence and identity: nurses and chronic conditions in a primary care setting Purpose – This paper aims to explore the ways in which practice nurses engage in identity work in the context of chronic disease management in primary care and assess the extent to which this is compatible with the identities promoted in government policy. Design/methodology/approach – The paper draws on qualitative interviews with nurses applying the concepts of “identity threat” and Hegel's Master‐Slave dialectic to explore the implications of nurse‐patient interdependence for identity in a policy context which aims to promote self‐management and patient empowerment. Findings – The nurses in the study showed little sign of adapting their identities in line with government policies intended to empower health care “consumers”. Instead, various aspects of identity work were identified which can be seen as helping to defend against identity threat and maintain and reproduce the traditional order. Practical implications – The paper provides information on barriers to self‐management that are likely to inhibit the implementation of government policy. Originality/value – Whilst much has been written on the extent to which patients are dependent on health professionals, the issue of professional dependence on patients has received much less attention. The paper hightlights how viewing the nurse‐patient relationship in the context of a struggle for mastery related to identity represents a departure from traditional approaches and sheds light on hitherto unexplored barriers to self‐management. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Health Organisation and Management Emerald Publishing

Dependence and identity: nurses and chronic conditions in a primary care setting

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Publisher
Emerald Publishing
Copyright
Copyright © 2008 Emerald Group Publishing Limited. All rights reserved.
ISSN
1477-7266
DOI
10.1108/14777260810883558
pmid
18700586
Publisher site
See Article on Publisher Site

Abstract

Purpose – This paper aims to explore the ways in which practice nurses engage in identity work in the context of chronic disease management in primary care and assess the extent to which this is compatible with the identities promoted in government policy. Design/methodology/approach – The paper draws on qualitative interviews with nurses applying the concepts of “identity threat” and Hegel's Master‐Slave dialectic to explore the implications of nurse‐patient interdependence for identity in a policy context which aims to promote self‐management and patient empowerment. Findings – The nurses in the study showed little sign of adapting their identities in line with government policies intended to empower health care “consumers”. Instead, various aspects of identity work were identified which can be seen as helping to defend against identity threat and maintain and reproduce the traditional order. Practical implications – The paper provides information on barriers to self‐management that are likely to inhibit the implementation of government policy. Originality/value – Whilst much has been written on the extent to which patients are dependent on health professionals, the issue of professional dependence on patients has received much less attention. The paper hightlights how viewing the nurse‐patient relationship in the context of a struggle for mastery related to identity represents a departure from traditional approaches and sheds light on hitherto unexplored barriers to self‐management.

Journal

Journal of Health Organisation and ManagementEmerald Publishing

Published: Jun 20, 2008

Keywords: Nurses; Primary care; Work identity

References

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