Powerlessness

Powerlessness

The phenomenon experienced by individuals with chronic illness, described as either real or perceived, and can be short-lived or persistent.

Paradox of powerlessness

Power and powerlessness exist simultaneously

Chronically ill live in a dual world

• Wellness/illness

• Power/powerlessness

• Hope/despair

Self-Determination Theory

A theory that emphasizes the importance of autonomy and self-regulation in determining one's health and well-being, especially relevant in the context of chronic illness. Suggests that all humans have three basic psychological needs—autonomy, competence, and relatedness—that underlie growth and development.

Biological Determinants

Genetics, age, and sex that may affect health outcomes.

Behavioral Determinants

Lifestyle choices such as diet, exercise, and smoking.

Environmental Determinants

Physical environment aspects including climate, pollution, and living conditions.

Health Care Determinants

Access to and quality of health care services.

Social Determinants

Conditions in which people are born, grow, live, and work, including factors such as education, income, employment, social support, and culture.

Shifting perspectives in chronic illness

The process of altering one's view or approach towards living with chronic illness, which can involve recognizing personal strengths, the impact of social support, and reframing experiences of powerlessness into opportunities for growth and self-determination.

Empowerment interventions/stressors

Powerlessness → shift to → Control

Illness at foreground → shift to → Wellness at foreground

Problems and Issues Associated with Powerlessness

• Loss

• Uncertainty

• Chronic illness management

• Lack of knowledge and health literacy

• Dignity

• Vulnerability

• Marginalization

• Stigma

• Culture

• Healthcare system

Chronic Illness Empowerment Interventions

• Health Coaching

• Care transition

• Collaboration

• Self-management

• Control

• Self-determination

• Cultural/Linguistic competence

• Cultural humility

Chronic Illness Knowledge Interventions

• Health navigation

• Advocacy

• Motivational interviewing

• Decision making

• Anticipatory guidance

Outcomes can be measured from three perspectives:

• Self

• Relationships with others

• Client behaviors

Evaluate changes in self by

Increased self-confidence and self-esteem. Interventions must focus on emotional responses.

Evaluating changes in relationships with others

• Family

• Friends

• Healthcare professionals

Evaluating changes in client behavior

• Personal views of symptoms

• Beliefs regarding prognosis and treatment