Myth of empowerment in chronic illness

Aims. This article presents several findings of a study, conducted between 1996 and 1998, to investigate self-care decision milking in diabetes. Rationale. The underlying assumption of man); practitioners is that an invi tation to people with chronic illness to participate as equal partners is s ufficient to guarantee their empowerment. Design. Using grounded theor), the research examined self-care decision mak ing using a convenience sample of 22 Canadian adults with longstanding type 1 diabetes nominated as expert self-cart managers. Participants audiotaped their decision making as it occurred for 3 weeks over the course of one ca lendar year. These audio-recordings were followed by an interview to clarif y participants' decision making and factors that affected their decisions. Findings. Participants identified several covert and subtle was that practi tioners contradict their stated goal of empowerment in their interactions w ith diabetics. Participants revealed that despite their intention to foster participatory decision making, practitioners frequently discount the exper iential knowledge of diabetes over time and do nor provide the resources ne cessary to make informed decisions. Conclusion. The article concludes with a discussion of the implications of the findings for practice.