How do people with COPD or diabetes type 2 experience autonomy? An exploratory study.
OBJECTIVE
To develop an empirically grounded conceptualization of personal autonomy in the context of chronic physical illness and to investigate the impact of two chronic illnesses on autonomy.


METHODS
Grounded theory study consisting of 13 in-depth interviews with older adults with Chronic Obstructive Pulmonary Disease (COPD) or diabetes mellitus type 2 (diabetes).


RESULTS
The results indicate that autonomy involves taking account of current circumstances as the frame of reference in which people can arrange their lives. Chronic illness disturbed autonomy by limiting opportunities and by prompting a reappraisal of the value that people placed on different activities or aspects of life. The participants responded to this disturbance differently, in ways that did not always restore autonomy. Limited opportunities occurred more often with COPD, while reappraisal occurred more often with diabetes.


CONCLUSIONS
Personal autonomy in the context of chronic physical illness might be conceptualized as correspondence between the way people's lives are actually arranged and the way people want their lives to be arranged, considering the circumstances. Health professionals could stimulate their clients to prevent and overcome impasses in the realisation of autonomy, while broad self-management interventions might improve people's skills for coping with the impact of chronic illness on autonomy.
Mars
Godelief M J
GM
The Maastricht Care and Public Health Research Institute, Netherlands School of Primary Care Research, Department of Health Care Studies, Faculty of Health Sciences, Universiteit Maastricht, Maastricht, The Netherlands. g.mars@zw.unimaas.nl
Proot
Ireen M
IM
Janssen
Peter P M
PP
van Eijk
Jacques Th M
JT
Kempen
Gertrudis I J M
GI
D000223:Adaptation, Psychological; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D026712:Value of Life