title: 'Permission to participate?' A qualitative study of participation in patients from differing socio-economic backgrounds.
abstract: Participation in health care is an important element of self-management in chronic illness, and policy emphasises patient's choice. Evidence suggests that this may be inequitable and inadequate, since active participation is strongly associated with socio-demographic variables. This qualitative study explores the perceptions of participation in people with differing socio-economic status with themes related to health literacy and relationship with health-care professionals. Patients perceive participation in different ways, related to their prior expectations of a health-care consultation, cultural expectations and social position. Policies aimed at simply improving 'health literacy' and choice will not be successful if these broader disparities are not addressed.
authors.affiliation: Institute of Primary Care and Health Sciences, Arthritis Research UK Primary Care Centre, Keele University, UK. j.protheroe@keele.ac.uk
authors.forename: Joanne
authors.initials: J
authors.lastname: Protheroe
authors.forename: Helen
authors.initials: H
authors.lastname: Brooks
authors.forename: Carolyn
authors.initials: C
authors.lastname: Chew-Graham
authors.forename: Caroline
authors.initials: C
authors.lastname: Gardner
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
mesh_terms: D000368:Aged; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000191:economics / Q000523:psychology*; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012923:Social Class
keywords: choice; health literacy; participation; self-management; shared decision-making