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      Facilitating Empowerment in Employees with Chronic Disease: Qualitative Analysis of the Process of Change

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          Abstract

          Introduction In the field of healthcare, empowering patients who have a chronic disease is defined as increasing their knowledge and skills, in order to enable them to define their treatment goals and take personal responsibility for their medical treatment. Our goal was to explore the nature of empowerment for employees who have a chronic disease and who experience work-related problems. Methods We used an explorative qualitative approach to document, from a professional perspective, the experiences of patients who participated in an empowerment training program. The researcher and the three instructors identified several themes which appeared to be important to many participants. These themes were fine-tuned and illustrated using brief case histories. Results We identified seven themes and characterized them in terms of employee tasks. These included: (1) developing a realistic understanding of one’s abilities, (2) standing up for oneself in a self-confident way, (3) maintaining social relations based on mutual understanding with supervisors and colleagues, (4) collecting and assimilating knowledge of one’s options, rights and duties, (5) consulting others and negotiating with regard to work accommodations, (6) planning one’s job so as to provide personal satisfaction, and (7) maintaining a social life outside work. Not every employee is faced with all of these tasks, but most have to deal with several. Conclusion Empowerment presupposes that employees with a chronic disease can act to solve problems at the workplace. The experiences during a comprehensive empowerment training illustrate that a process of reflection on personal emotions and a cognitive process of exploration and identification of bottlenecks at work may precede these actions. Our primary contribution is the aforementioned list of seven common tasks that many workers have to perform. Disseminating the list can support employees who have a chronic disease and may also be useful for their managers, HRM staff, occupational health and other healthcare workers.

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          Most cited references27

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          Empowerment theory, research, and application

          This introduction to the special issue briefly reviews the meaning and significance of the empowerment concept and problems associated with the proliferation of interest in empowerment. We identify some of the topics not included in this issue and relate those to the many broad and diverse areas of psychological empowerment theory and community-based research and intervention that are covered. We present synopses of each article along with some of the themes and lessons cutting across the frameworks, studies, and applications. These include a wide diversity of settings, fairly representative of empowerment interventions, and, at the same time, improved clarity (if not unanimity) of definitions and measurement, which has been a problem in much empowerment research and intervention.
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            Loss of self: a fundamental form of suffering in the chronically ill.

            K Charmaz (1983)
            Physical pain, psychological distress and the deleterious effects of medical procedures all cause the chronically ill to suffer as they experience their illnesses. However, a narrow medicalized view of suffering, solely defined as physical discomfort, ignores or minimizes the broader significance of the suffering experienced by debilitated chronically ill adults. A fundamental form of that suffering is the loss of self in chronically ill persons who observe their former self-images crumbling away without the simultaneous development of equally valued new ones. As a result of their illnesses, these individuals suffer from (1) leading restricted lives, (2) experiencing social isolation, (3) being discredited and (4) burdening others. Each of these four scores of suffering is analysed in relation to its effects on the consciousness of the ill person. The data are drawn from a qualitative study of 57 chronically ill persons with varied diagnoses.
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              Patient empowerment. Results of a randomized controlled trial.

              The purpose of this study was to determine if participation in a patient empowerment program would result in improved psychosocial self-efficacy and attitudes toward diabetes, as well as a reduction in blood glucose levels. This study was conducted as a randomized, wait-listed control group trial. The intervention group received a six-session (one session per week) patient empowerment education program; the control group was assigned to a wait-list. At the end of 6 weeks, the control group completed the six-session empowerment program. Six weeks after the program, both groups provided follow-up data. The intervention group showed gains over the control group on four of the eight self-efficacy subscales and two of the five diabetes attitude subscales. Also, the intervention group showed a significant reduction in glycated hemoglobin levels. Within groups, analysis of data from all program participants showed sustained improvements in all of the self-efficacy areas and two of the five diabetes attitude subscales and a modest improvement in blood glucose levels. This study indicated that patient empowerment is an effective approach to developing educational interventions for addressing the psychosocial aspects of living with diabetes. Furthermore, patient empowerment is conducive to improving blood glucose control. In an ideal setting, patient education would address equally blood glucose management and the psychosocial challenges of living with diabetes.
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                Author and article information

                Contributors
                i.varekamp@amc.nl
                Journal
                J Occup Rehabil
                Journal of Occupational Rehabilitation
                Springer US (Boston )
                1053-0487
                1573-3688
                7 July 2009
                December 2009
                : 19
                : 4
                : 398-408
                Affiliations
                [1 ]Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, P.O. Box 22600, 1100 DD Amsterdam, The Netherlands
                [2 ]Arbo Unie Occupational Health Service, Amsterdam, The Netherlands
                [3 ]Department of Psychiatry, Programme for Mood Disorders, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
                Article
                9188
                10.1007/s10926-009-9188-x
                2775116
                19582552
                7452d00b-2756-4724-b7a6-d9c7afa36dcc
                © The Author(s) 2009
                History
                : 21 November 2008
                : 5 June 2009
                Categories
                Article
                Custom metadata
                © Springer Science+Business Media, LLC 2009

                Occupational & Environmental medicine
                workplace,job retention,rehabilitation, vocational,occupational health,chronic disease,job satisfaction,return to work,employment,work disability,disability management

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