Beyond the realist turn

A Socio-Material Analysis of Heart Failure Self-Care

Bibliographic Data

ID2249367
AuthorsAllan Mcdougall (0000-0002-0418-0614, Centre for Education Research and Innovation Schulich School of Medicine & Dentistry Western University Ontario Canada, corresponding author), Elizabeth Anne Kinsella (0000-0002-7306-7957, Occupational Therapy Western University Ontario Canada), Mark Goldszmidt (0000-0002-5861-5222, Centre for Education Research and Innovation Schulich School of Medicine & Dentistry Western University Ontario Canada), Karen Harkne (0000-0001-5704-1469, Cardiac Care Network of Ontario Ontario Canada), Patricia H Strachan (0000-0003-3121-4442, Department of Nursing McMaster University Ontario Canada), Lorelei Lingard (0000-0002-1524-0723, Centre for Education Research and Innovation Schulich School of Medicine & Dentistry Western University Ontario Canada)
Year2018
Volume40
Issue1
Pages218-233
Publication date2018-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12675
PMID29349880
OpenAlexW2792918383
LanguageEN
Citations received10
References cited68

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body ofHFstudies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' inHFself-care. Realist evaluation and realist interventions emphasise that the relationship between self-care interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts ofHFself-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advancedHF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influenceHFself-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality

Aesthetics · Context (archaeology · Economic growth · Economics · Health care · Materiality (auditing · Narrative · Psychological intervention · Quality of life (healthcare · Self care · Sociology · Geriatric Care and Nursing Homes · Healthcare innovation and challenges · Medicine · Mental Health and Patient Involvement · Nursing · Psychology · Social Psychology