Conceptions of Personal Autonomy in Family Relationships in Japan

ObjectivesThe rapid worldwide increase in the incidence of diabetes significantly influences the lives of individuals, families and communities. Diabetes self-management requires personal autonomy and the presence of a supportive social environment. These attributes can considerably ameliorate the outcomes of the chronic condition. However, little is known about individual variations in overcoming the illness-related challenges and in the achievement of autonomy in daily activities. This paper seeks to bridge this knowledge gap.DesignThis qualitative study used the grounded theory approach. Semi-structured interviews were conducted, and the data collection and data analysis probed participant experiences of autonomy through the self-management of their daily socio-physical environments.SettingParticipants were recruited from the outpatient ward of a university clinic in Hungary.ParticipantsThe study was conducted with 26 adult patients with type 2 diabetes mellitus (15 females and 11 males aged between 26 and 80 years; M=62.6 years; SD=13.1). The inclusion criteria were: T2D diagnosis at least 1 year before the beginning of the study; prescribed insulin injection therapy; aged over 18 years; native Hungarian speaker and not diagnosed with dementia or any form of cognitive impairment.ResultsThe study established three principal aspects of the active construction of personal autonomy in diabetes self-management: coping strategies vis-à-vis threats posed by the symptoms and the treatment of the disease; autonomous ways of creating protective space and time and relationship processes that support everyday experiences of self-directedness.ConclusionsThe results of this study confirm the validity of the self-determination theory in diabetes self-management. They also imply that pathways towards constructing everyday experiences of self-directedness in participants lead through self-acceptance, supporting family relationships and a doctor–patient relationship characterised by partnership. The tentative empirical model of pathways towards patients’ experience of self-directedness can serve as a framework for future research, patient-centred clinical practice, and education.

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Family relationships and counselling

British Journal of Guidance and Counselling ◽

10.1080/03069888500760061 ◽

1995 ◽

Vol 13 (1) ◽

pp. 60-74 ◽

Cited By ~ 1

Author(s):

Stephen Murgatroyd ◽

Brian Cade ◽

Michael Shooter

Keyword(s):

Family Relationships

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The SRM Approach to Family Assessment

European Journal of Psychological Assessment ◽

10.1027/1015-5759.21.4.216 ◽

2005 ◽

Vol 21 (4) ◽

pp. 216-225 ◽

Cited By ~ 21

Author(s):

William L. Cook

Keyword(s):

High Risk ◽

Risk Behaviors ◽

Social Relations ◽

Family Relationships ◽

Family Dynamics ◽

Family Assessment ◽

High Risk Behaviors ◽

Analysis Group ◽

The Social ◽

Direction Of Effects

Abstract. In family systems, it is possible for one to put oneself at risk by eliciting aversive, high-risk behaviors from others ( Cook, Kenny, & Goldstein, 1991 ). Consequently, it is desirable that family assessments should clarify the direction of effects when evaluating family dynamics. In this paper a new method of family assessment will be presented that identifies bidirectional influence processes in family relationships. Based on the Social Relations Model (SRM: Kenny & La Voie, 1984 ), the SRM Family Assessment provides information about the give and take of family dynamics at three levels of analysis: group, individual, and dyad. The method will be briefly illustrated by the assessment of a family from the PIER Program, a randomized clinical trial of an intervention to prevent the onset of psychosis in high-risk young people.

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