liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Patient participation in decision-making about cardiovascular preventive drugs - resistance as agency
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Primary Care Center, Primary Health Care Center Åby.
Kalmar County Council, Sweden; University of Tromso, Norway.
2017 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 35, no 3, p. 231-239Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of the study was to describe and explore patient agency through resistance in decision-making about cardiovascular preventive drugs in primary care. Design: Six general practitioners from the southeast of Sweden audiorecorded 80 consultations. From these, 28 consultations with proposals from GPs for cardiovascular preventive drug treatments were chosen for theme-oriented discourse analysis. Results: The study shows how patients participate in decision-making about cardiovascular preventive drug treatments through resistance in response to treatment proposals. Passive modes of resistance were withheld responses and minimal unmarked acknowledgements. Active modes were to ask questions, contest the address of an inclusive we, present an identity as a non-drugtaker, disclose non-adherence to drug treatments, and to present counterproposals. The active forms were also found in anticipation to treatment proposals from the GPs. Patients and GPs sometimes displayed mutual renouncement of responsibility for decision-making. The decision-making process appeared to expand both beyond a particular phase in the consultations and beyond the single consultation. Conclusions: The recognition of active and passive resistance from patients as one way of exerting agency may prove valuable when working for patient participation in clinical practice, education and research about patient-doctor communication about cardiovascular preventive medication. We propose particular attentiveness to patient agency through anticipatory resistance, patients disclosures of non-adherence and presentations of themselves as non-drugtakers. The expansion of the decision-making process beyond single encounters points to the importance of continuity of care.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2017. Vol. 35, no 3, p. 231-239
Keywords [en]
Communication; shared decision-making; prevention; cardiovascular drugs; cardiovascular diseases; general practice; qualitative research; Sweden
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:liu:diva-141136DOI: 10.1080/02813432.2017.1288814ISI: 000409262100002PubMedID: 28277056OAI: oai:DiVA.org:liu-141136DiVA, id: diva2:1144732
Note

Funding Agencies|ALF Grants, Region Ostergotland; Research Board of Local Care Eastern Ostergotland; Research and Development Unit of the County Council of Ostergotland; Research Council of South Eastern Sweden (FORSS)

Available from: 2017-09-27 Created: 2017-09-27 Last updated: 2018-04-18

Open Access in DiVA

fulltext(1071 kB)22 downloads
File information
File name FULLTEXT01.pdfFile size 1071 kBChecksum SHA-512
08b23bf22762eee9e90fc13e4b877db7c398c4efcbfcbf4f0eecbac4759949f6d11026c205ddda497b9eb6af62e76f756da34ceb835d8bf1a93fe62d9d02e214
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Hultberg, JosabethRudebeck, Carl-Edvard
By organisation
Division of Community MedicineFaculty of Medicine and Health SciencesPrimary Health Care Center Åby
In the same journal
Scandinavian Journal of Primary Health Care
Social and Clinical Pharmacy

Search outside of DiVA

GoogleGoogle Scholar
Total: 22 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 36 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf