{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:08:49Z","timestamp":1789848529366,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008473","name":"Bournemouth University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008473","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Inquiry"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Empowerment is a widely used term in healthcare literature, policy and practice, but its meaning is often inconsistent and increasingly framed as an individual outcome linked to self\u2010management, responsibility and compliance. However, such framings risk oversimplifying empowerment and reinforcing neoliberal and paternalistic assumptions that place responsibility on individuals while overlooking wider relational, systemic and contextual influences. Drawing on findings from constructivist grounded theory research with people affected by advanced liver disease, carers and healthcare professionals, I propose that empowerment is not a fixed state or something that can be delivered by professionals, but rather a dynamic, relational process that exists on a continuum and frequently co\u2010exists with disempowerment. Rather than being an outcome to be achieved, empowerment is enacted through everyday actions, relationships, resistance and navigation of constraint across patients, carers and professionals. The paper proposes a reconceptualisation of empowerment as relational, contextual and co\u2010produced, with implications for moving away from notions of empowerment as professional intervention or individual achievement.<\/jats:p>","DOI":"10.1111\/nin.70167","type":"journal-article","created":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:53:51Z","timestamp":1789847631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rethinking Empowerment in Healthcare: A Dynamic Continuum"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3861-3465","authenticated-orcid":false,"given":"Cathy J.","family":"Beresford","sequence":"first","affiliation":[{"name":"Department of Nursing University of Sunderland in London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,19]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2020.108446"},{"key":"e_1_2_13_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-1-349-14033-6","volume-title":"Social Work and Empowerment","author":"Adams R.","year":"1996"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2018.07.026"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.70444"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2009.07.025"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.09.008"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2020.05.008"},{"key":"e_1_2_13_9_1","unstructured":"Beresford C. J.2025. \u201cCare Experiences in Decompensated Advanced Liver Disease. Perspectives of People With Lived Experience Carers and Professionals.\u201d PhD thesis Bournemouth University."},{"key":"e_1_2_13_10_1","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-349-22544-6","volume-title":"Citizen Involvement: A Practical Guide for Change","author":"Beresford P.","year":"1993"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2003.09.002"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.ep11339939"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0969733020966776"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0080-623420160000500018"},{"key":"e_1_2_13_15_1","volume-title":"On Our Own: Patient\u2010Controlled Alternatives to the Mental Health System","author":"Chamberlin J.","year":"1978"},{"key":"e_1_2_13_16_1","series-title":"Introducing Qualitative Methods","volume-title":"Constructing Grounded Theory","author":"Charmaz K.","year":"2025"},{"key":"e_1_2_13_17_1","unstructured":"Department of Health and Social Care.2018. \u201cHealth Profile for England: 2018\u2014Chapter 6: Wider Determinants of Health\u201d.https:\/\/www.gov.uk\/government\/publications\/health-profile-for-england-2018\/chapter-6-wider-determinants-of-health."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10728-016-0335-1"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2006.05.002"},{"key":"e_1_2_13_20_1","volume-title":"Pedagogy of the Oppressed","author":"Freire P.","year":"2018"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780198237907.001.0001","volume-title":"Epistemic Injustice: Power and the Ethics of Knowing","author":"Fricker M.","year":"2007"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/014572179101700108"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.1991.tb01660.x"},{"key":"e_1_2_13_24_1","volume-title":"Black Power: Politics of Liberation in America","author":"Hamilton C. V.","year":"2011"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2011.0287"},{"key":"e_1_2_13_26_1","volume-title":"Feminist Theory: From Margin to Center","author":"Hooks Bell","year":"1984"},{"issue":"1","key":"e_1_2_13_27_1","doi-asserted-by":"crossref","DOI":"10.4103\/jehp.jehp_565_23","article-title":"A Scoping Review of Individual Health Responsibility: A Context\u2010Base Concept","volume":"13","author":"Hosseini Nodeh Z.","year":"2024","journal-title":"Journal of Education and Health Promotion"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-024-02573-w"},{"key":"e_1_2_13_29_1","doi-asserted-by":"publisher","DOI":"10.5195\/cajgh.2020.419"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nedt.2014.11.014"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2011.02.010"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15424"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1383150"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-12-157"},{"key":"e_1_2_13_35_1","volume-title":"The Sociology of Health and Illness","author":"Nettleton S.","year":"2021"},{"key":"e_1_2_13_36_1","unstructured":"NHS England.2025. \u201cEmpowering People\u201d.https:\/\/www.england.nhs.uk\/digitaltechnology\/empowering-people\/."},{"key":"e_1_2_13_37_1","unstructured":"NHS England.2026. \u201cEmpowering Patients\u201d.https:\/\/www.england.nhs.uk\/patient-safety\/patient-safety-insight\/patient-safety-alerts\/enduring-standards\/informing-broader-local-safety-initiatives\/empowering-patients\/."},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0018246X12000611"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2019.10.019"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00896357"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.1996.tb02672.x"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13010-022-00126-0"},{"key":"e_1_2_13_43_1","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-024-02323-1","article-title":"Is This Really Empowerment? Enhancing Our Understanding of Empowerment in Patient and Public Involvement Within Clinical Research","volume":"24","author":"Schilling I.","year":"2024","journal-title":"BMC Medical Research Methodology"},{"key":"e_1_2_13_44_1","doi-asserted-by":"crossref","DOI":"10.4324\/9780203640098","volume-title":"Disability Rights and Wrongs","author":"Shakespeare T.","year":"2006"},{"key":"e_1_2_13_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-13-263"},{"key":"e_1_2_13_46_1","volume-title":"Black Empowerment: Social Work in Oppressed Communities","author":"Solomon B. B.","year":"1976"},{"key":"e_1_2_13_47_1","doi-asserted-by":"publisher","DOI":"10.1191\/1463423603pc141oa"},{"key":"e_1_2_13_48_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjcn.2024.0035"},{"key":"e_1_2_13_49_1","volume-title":"Empowerment in Practice: Analysis and Implementation","author":"World Bank","year":"2007"},{"key":"e_1_2_13_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2025.03.032"},{"key":"e_1_2_13_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02506983"}],"container-title":["Nursing Inquiry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nin.70167","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nin.70167","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nin.70167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:53:56Z","timestamp":1789847636000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nin.70167"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":50,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/nin.70167"],"URL":"https:\/\/doi.org\/10.1111\/nin.70167","archive":["Portico"],"relation":{},"ISSN":["1320-7881","1440-1800"],"issn-type":[{"value":"1320-7881","type":"print"},{"value":"1440-1800","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]},"assertion":[{"value":"2026-06-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70167"}}