Who's in charge? The role of responsibility attribution in self-management among people with chronic illness.
OBJECTIVE
To explore how responsibility attribution influences self-management regimens among people with chronic illness.


METHODS
This qualitative content analysis included 26 interviews with people living with chronic illness.


RESULTS
The participants attributed responsibility to internal, external or a combination of these factors, meaning that they either assumed responsibility for self-management or considered other people or factors responsible. Internal responsibility was associated with a multifaceted self-management regimen, whereas external responsibility was related to "conventional" self-management such as taking medication, managing symptoms and lifestyle changes.


CONCLUSIONS
How responsibility is attributed is vital for the way in which individuals perform self-management. In this study, those who attributed responsibility to external factors mainly performed recommended behaviours to control their illness. In contrast, to take charge of their illness and be an active participant in the care, individuals must take responsibility for themselves, i.e. internal responsibility.


CONCLUSIONS
Health-care providers should acknowledge and support individuals' wishes about various levels of responsibility as well as different kinds of patient-provider relationships.
Audulv
Asa
A
Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden. audulv@hotmail.com
Asplund
Kenneth
K
Norbergh
Karl-Gustaf
KG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000523:psychology; D003657:Decision Making; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D033262:Narration; D010349:Patient Compliance; D011369:Professional-Patient Relations; D012648:Self Care / Q000523:psychology; D012944:Social Support; D013548:Sweden