title: Economic rationality and health and lifestyle choices for people with diabetes.
abstract: Economic rationality is traditionally represented by goal-oriented, maximising behaviour, or 'instrumental rationality'. Such a consequentialist, instrumental model of choice is often implicit in a biomedical approach to health promotion and education. The research reported here assesses the relevance of a broader conceptual framework of rationality, which includes 'procedural' and 'expressive' rationality as complements to an instrumental model of rationality, in a health context. Q methodology was used to derive 'factors' underlying health and lifestyle choices, based on a factor analysis of the results of a card sorting procedure undertaken by 27 adult respondents with type 2 diabetes in Newcastle upon Tyne, UK. These factors were then compared with the rationality framework and the appropriateness of an extended model of economic rationality as a means of better understanding health and lifestyle choices was assessed. Taking a wider rational choice perspective, choices which are rendered irrational within a narrow-biomedical or strictly instrumental model, can be understood in terms of a coherent rationale, grounded in the accounts of respondents. The implications of these findings are discussed in terms of rational choice theory and diabetes management and research.
authors.affiliation: School of Population and Health Sciences, Centre for Health Services Research, University of Newcastle upon Tyne, Newcastle upon Tyne NE2 4AA, UK. r.m.baker@ncl.ac.uk
authors.forename: Rachel Mairi
authors.initials: RM
authors.lastname: Baker
mesh_terms: D000328:Adult; D000368:Aged; D002755:Choice Behavior; D003924:Diabetes Mellitus, Type 2; D004467:Economics; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008019:Life Style; D008297:Male; D011908:Rationalization; D012648:Self Care; D006113:United Kingdom