{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:25:44Z","timestamp":1783913144201,"version":"3.55.0"},"reference-count":40,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Med Humanities"],"accepted":{"date-parts":[[2019,2,28]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>A patient-centred approach has gained increasing interest in medicine and other health sciences. Whereas there are discussions about the meaning of a patient-centred approach and what the concept entails, little is known about how the patient as a person is understood in patient-centred care. This article investigates understandings of the patient as a self in patient-centred care through physiotherapy of patients with chronic muscle pain. The material consists of interviews with five Norwegian physiotherapists working in a rehabilitation clinic. Drawing on Kristeva\u2019s discussion of subjectivity in medical discourse, the study highlights two different treatment storylines that were closely entwined. One storyline focuses on open singular healing processes in which the treatment was based on openness to a search for meaning and sharing. In this storyline, the \u201cperson\u201c at the centre of care was not essentialised in terms of biological mechanisms, but rather considered as a vulnerable, irrational and moving self. By contrast, the second storyline focused on goal-oriented interventions aimed at restoring the patient to health. Here, the person in the centre of the treatment was shaped according to model narratives about \u201cthe successful patient\u201d; the empowered, rational, choosing and self-managing individual. As such, the findings revealed two conflicting concepts of the individual patient inherent in patient-centred care. On the one hand, the patient is seen as being a person in constant movement, and on the other, they are captured by more standardised terms designed to focus on a more stable notion of outcome of illness. Therefore, our study suggests that the therapists\u2019 will to recognise the individual in patient-centred care had a counterpart involving a marginalisation of the singular.<\/jats:p>","DOI":"10.1136\/medhum-2018-011603","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T06:52:11Z","timestamp":1553755931000},"page":"226-233","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["The singular patient in patient-centred care: physiotherapists\u2019 accounts of treatment of patients with chronic muscle pain"],"prefix":"10.1136","volume":"46","author":[{"given":"Birgitte","family":"Ahlsen","sequence":"first","affiliation":[{"name":"Physiotherapy, OsloMet - Oslo Metropolitan University Faculty of Health Sciences, Oslo, Norway"},{"name":"Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eivind","family":"Engebretsen","sequence":"additional","affiliation":[{"name":"Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nicholls","sequence":"additional","affiliation":[{"name":"School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marit","family":"Mengshoel","sequence":"additional","affiliation":[{"name":"Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,27]]},"reference":[{"key":"2025092411555886000_46.3.226.1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2017-011229"},{"key":"2025092411555886000_46.3.226.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0277-9536(00)00351-8"},{"key":"2025092411555886000_46.3.226.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"2025092411555886000_46.3.226.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(99)00087-7"},{"key":"2025092411555886000_46.3.226.5","doi-asserted-by":"publisher","DOI":"10.1086\/448619"},{"key":"2025092411555886000_46.3.226.6","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.ep11339939"},{"issue":"6","key":"2025092411555886000_46.3.226.7","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1177\/0269215517752488","article-title":"A Qualitative Investigation into the Patient-Centered Goal-Setting Practices of Allied Health Clinicians Working in Rehabilitation","volume":"32","author":"Cameron","year":"2018","journal-title":"Clinical Rehabilitation"},{"key":"2025092411555886000_46.3.226.8","doi-asserted-by":"crossref","unstructured":"Charon Rita . 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