Empower Me? Yes, Please, But in My Way: Different Patterns of Experiencing Empowerment in Patients with Chronic Conditions

Abstract

Empowerment is a widely used word within the realm of health care. This is especially true in the case of patients living with a chronic illness, who may be active participants and learn to manage their disease, irrespective of their desires or preferences. This article focuses on the empowering experience of patients with chronic conditions. We have built on earlier research that explains the factors that mediate communication between health care professionals and patients: patient participation, patient impact, meaning, health care professionals’ information provision, health care professionals’ emotional support, health care professionals’ attentive listening, health care professionals’ trust, and patient collaboration. We propose a new model for detecting types of patients who differ in the way they live their empowering experience. Using survey data from a sample of 181 patients of hemophilia, we found two types of patients: patients with an inner locus of empowerment and patients with an outer locus of empowerment. We conclude by discussing different strategies for fostering the sense of power in each of these types of patients. The importance of empowerment in the health care field reflects a change in the model of caregivers and patients’ communication toward higher doses of mutual collaboration. This move can be justified in terms of ethical considerations, cost controlling, health outcomes, and nonhealth outcomes. Empowerment can be a conceptually complex idea, with different meanings depending on the people and depending on the context. Empowerment meets narrative: Listening to stories and creating settings. In a general sense, empowerment can be defined “as the process by which people gain mastery over their affairs”. In health care delivery, according to Funnell et al. “patients are empowered when they have knowledge, skills, attitudes and self-awareness necessary to influence their own behavior and that of others in order to improve the quality of their lives.” Asimakopoulou, Gilbert, Newton, and Scambler argued that focusing on the patient is the necessary condition for empowerment: “the foundation upon which ‘well informed, active partners in their own care’ are built” (p. 282). This notion of patients as informed and active participants is particularly relevant in the area of chronic illnesses. Patients with a chronic illness must be involved in their own care. Empowerment is an omnipresent facet of the way that patients live their illness. Previous literature has analyzed different aspects of patient empowerment; however, little is known about the empowerment experience per se. To fill this gap, in this article, we analyze the empowerment experience of patients with chronic illnesses.