'Rule your condition, don't let it rule you': Young adults' sense of mastery in their accounts of growing up with a chronic illness
Sociology of Health and Illness: a journal of medical sociology
Copyright © 2015 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL. This is an open access article under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Poor control of chronic illness is often attributed to patients’ non-adherence to medical advice and treatment. Policy and practice has traditionally focussed on improving adherence, assuming that the more patients adhere, the better their control and outcomes will be. Drawing on complexity theory, we question this logic in a secondary analysis of qualitative data from studies of young adults’ experiences of growing up with a chronic illness. Examining their sense of mastery of their condition, we found they valued both being in medical control of their condition and having autonomy but had different ideas about how to achieve these goals. While some young adults mostly shared the traditional medical view that achieving good control was the key to retaining their autonomy, others saw control and autonomy as independent, non-linear and potentially conflicting goals. The latter endeavoured to achieve both goals by striking a balance, variously adopting strategies of engagement with and resistance to their regime in the changing social contexts of their lives. We suggest that policy and practice needs to do more to promote autonomy and adaptive capacity, rather than simply maximising adherence and control, recognising the mundane complexity of living with and managing a chronic illness.
Economic and Social Research Council (ESRC)
Open Access article
This is the peer reviewed version of the following article: Heaton, J., Räisänen, U. and Salinas, M. (2015), ‘Rule your condition, don't let it rule you’: young adults’ sense of mastery in their accounts of growing up with a chronic illness. Sociology of Health & Illness, which has been published in final form at 10.1111/1467-9566.12298. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving: http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms