Keele Research Repository
Explore the Repository
Morden, A, Ong, BN, Jinks, C, Healey, EL, Finney, A and Dziedzic, KS (2020) Resistance or appropriation? : Uptake of exercise after a nurse-led intervention to promote self-management for osteoarthritis. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine. ISSN 1363-4593
This is the latest version of this item.
Health-19-0233.R2_Proof_hi.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial.
Download (261kB) | Preview
![[thumbnail of Title and abstract.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Title and abstract.docx - Accepted Version
Available under License Creative Commons Attribution Non-commercial.
Download (11kB)
![[thumbnail of Habermas self-management revised FINAL3.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Habermas self-management revised FINAL3.docx - Accepted Version
Available under License Creative Commons Attribution Non-commercial.
Download (73kB)
![[thumbnail of Acknowledgements.docx]](https://eprints.keele.ac.uk/style/images/fileicons/text.png)
Acknowledgements.docx - Accepted Version
Available under License Creative Commons Attribution Non-commercial.
Download (10kB)
1363459320925879.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.
Download (290kB) | Preview
Abstract
The philosophical underpinning of trials of complex interventions is critiqued for not taking into account causal mechanisms that influence potential outcomes. In this article, we draw from in-depth interviews (with practice nurses and patients) and observations of practice meetings and consultations to investigate the outcomes of a complex intervention to promote self-management (in particular exercise) for osteoarthritis in primary care settings. We argue that nurses interpreted the intervention as underpinned by the need to educate rather than work with patients, and, drawing from Habermasian theory, we argue that expert medicalised knowledge (system) clashed with lay 'lifeworld' prerogatives in an uneven communicative arena (the consultation). In turn, the advice and instructions given to patients were not always commensurate with their 'lifeworld'. Consequently, patients struggled to embed exercise routines into their daily lives for reasons of unsuitable locality, sense-making that 'home' was an inappropriate place to exercise and using embodied knowledge to test the efficacy of exercise on pain. We conclude by arguing that using Habermasian theory helped to understand reasons why the trial failed to increase exercise levels. Our findings suggest that communication styles influence the outcomes of self-management interventions, reinforce the utility of theoretically informed qualitative research embedded within trials to improve conduct and outcomes and indicate incorporating perspectives from human geography can enhance Habermas-informed research and theorising.
Item Type: | Article |
---|---|
Additional Information: | https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
Uncontrolled Keywords: | Osteoarthritis, complex interventions, qualitative methods, Habermas, process evaluation, public health |
Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system R Medicine > RC Internal medicine > RC927 Rheumatism |
Divisions: | Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care |
Related URLs: | |
Depositing User: | Symplectic |
Date Deposited: | 24 Feb 2021 10:00 |
Last Modified: | 24 Feb 2021 10:00 |
URI: | https://eprints.keele.ac.uk/id/eprint/9179 |
Available Versions of this Item
-
Resistance or appropriation?: uptake of exercise after a nurse led intervention to promote self-management for osteoarthritis. (deposited 25 Mar 2020 14:52)
- Resistance or appropriation? : Uptake of exercise after a nurse-led intervention to promote self-management for osteoarthritis. (deposited 24 Feb 2021 10:00) [Currently Displayed]