title: The influence of confirming and disconfirming healthcare encounters on the self-relation and quality of life of persons with epilepsy.
abstract: The nature of epilepsy-related healthcare encounters is important for the self-relation and quality of life of patients with epilepsy. Seventeen positive and 16 negative encounters (critical incident method) were hermeneutically interpreted by an action-theoretic and confirmatory framework. For patients with positive self-assessment (SA), confirming (positive) encounters were intimately related to feelings of partnership and of manageability of their life situation and future. For patients with negative SA, confirming encounters showed that their struggle for human worth had succeeded and their dependence on positive evidence and energy from the healthcare professional was evident. Disconfirming encounters for patients with positive SA were closely linked to experiences of nonchalance and not being taken seriously as resourceful persons, and for patients with negative SA, being objectified as persons without getting any help in their troublesome life situations. The quality of life was especially improved for patients with positive SA by creating and revising life projects, and for patients with negative SA by engaging in social activities. Patients with positive SA and negative SA have different expectations and demands on encounters. This information could be of help in developing programs for encounters based on patients' own evaluation of their self-esteem and their expectations of care and nursing.
authors.affiliation: Karlstad University, Division for Health and Care, PO Box 9501, SE-65188 Karlstad, Sweden.
authors.forename: Lena K A
authors.initials: LK
authors.lastname: Räty
authors.forename: Barbro
authors.initials: B
authors.lastname: Gustafsson
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002983:Clinical Competence; D004827:Epilepsy / Q000451:nursing* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016294:Models, Nursing; D009723:Nurse-Patient Relations; D011788:Quality of Life; D012649:Self Concept; D012647:Self-Assessment