{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:09:12Z","timestamp":1765609752691,"version":"3.37.3"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T00:00:00Z","timestamp":1485993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["70\u201073000\u201098\u2010004"],"award-info":[{"award-number":["70\u201073000\u201098\u2010004"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and context<\/jats:title><jats:p>Many countries are giving patients a more active role in health care, on both the individual and collective level. This study focuses on one aspect of the participation agenda on the individual level: self\u2010management. The study explores self\u2010management in practice, including the implications of the difficulties encountered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To gain insight into the complexity of self\u2010management practice. This is crucial for developing both self\u2010management interventions and the participation policy agenda.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Qualitative semi\u2010structured interviews with experts (n=6) and patients with a chronic condition (n=20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In terms of level of involvement and type of activity, shaping self\u2010management in practice depends on personal and social dynamics, patients\u2019 ideas of the good life and their interactions with care professionals. Clashes can arise when patients and professionals hold differing ideas, based on different values, about the level and type of patient involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The discussion on self\u2010management should account for the fact that how we define self\u2010management is very much a normative issue. It depends on the norms and values of patients, professionals and underlying health\u2010care policies. Differing ideas present professionals with ethical dilemmas which they should reflect on. However, professional reflection alone is not enough to deal with these dilemmas. The participation agenda needs far wider ranging reflection on how participation relates to other values in health care.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.12536","type":"journal-article","created":{"date-parts":[[2017,2,2]],"date-time":"2017-02-02T17:21:08Z","timestamp":1486056068000},"page":"952-960","source":"Crossref","is-referenced-by-count":33,"title":["The complexity of shaping self\u2010management in daily practice"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6412-2707","authenticated-orcid":false,"given":"Hester M.","family":"van de Bovenkamp","sequence":"first","affiliation":[{"name":"Institute of Health Policy &amp; Management Erasmus University Rotterdam  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolanda","family":"Dwarswaard","sequence":"additional","affiliation":[{"name":"Research Centre Innovations of Care Rotterdam University of Applied Sciences  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,2,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.05.017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742395310380281"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12113"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2009.00567.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.12346"},{"volume-title":"The Limits of Patient Power: Examining Active Citizenship in Dutch Health Care","year":"2010","author":"Van de Bovenkamp H","key":"e_1_2_7_7_1"},{"key":"e_1_2_7_8_1","first-page":"182","volume-title":"The Oxford Handbook of Public Management","author":"Bovens MAP","year":"2005"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.5117\/9789053568194"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.5553\/BenM\/138900692015042002003"},{"key":"e_1_2_7_11_1","doi-asserted-by":"crossref","DOI":"10.4135\/9781446213551","volume-title":"Creating Citizen Consumers: Changing Publics and Changing Public Services","author":"Clarke J","year":"2007"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12316"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102013\u2010003583"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019\u20100169712\u20107"},{"key":"e_1_2_7_15_1","first-page":"176","volume-title":"Patient Participation in Health Care Consultations","author":"Thompson A","year":"2007"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4163"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2005.06.003"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742395311416138"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2013.10.008"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1742395310383338"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732304272048"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-9824.2011.01085.x"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-9824.2011.01096.x"},{"key":"e_1_2_7_24_1","first-page":"353","article-title":"Improving the outcomes of disease management by tailoring care to the patient's level of activation","volume":"15","author":"Hibbard J","year":"2009","journal-title":"Am J Manag Care"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(94)00155-M"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.3109\/09638288.2013.776645"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/jme.2009.030973"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732308316346"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/17423953060020031301"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638280210151996"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2004.05.008"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733013500806"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2648.1999.01037.x"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369-7625.2011.00748.x"},{"key":"e_1_2_7_35_1","unstructured":"RutzS Van de BovenkampH BuitenduikS RobbenP De BontA.How the views of young care users on quality of care clash with inspectors\u2019 assessment criteria: a case study of the involvement of adolescents in inspections. 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