{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:48:36Z","timestamp":1792259316033,"version":"4.4.0"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100008473","name":"Bournemouth University","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100008473","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Lewis-Manning Hospice Care","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chronic Illness"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Liver disease is a leading cause of morbidity and mortality, with alcohol-related liver disease, metabolic-associated steatotic liver disease, and viral hepatitis comprising most cases in the UK. Advanced liver disease presents challenges due to unpredictable disease trajectories, high symptom burden, psychosocial impacts, and stigma. This study aimed to develop an explanatory theory of care experiences in decompensated advanced liver disease from the perspectives of individuals living with the condition, carers, and healthcare professionals, with public involvement embedded throughout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using Charmaz's Constructivist Grounded Theory methodology, semi-structured interviews were conducted across the UK with individuals with advanced liver disease, carers, and healthcare professionals. Data collection and analysis occurred concurrently using constant comparison, focused coding, memoing, and theoretical sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-four people participated in interviews. Analysis generated the Empowerment Continuum, an explanatory theory conceptualising empowerment as a dynamic, relational process shaped by personal, relational, and systemic factors. Five conceptual categories informed the theory: self-care, navigating healthcare services, healthcare professionals\u2019 contributions, carers\u2019 involvement and support, and information and communication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The Empowerment Continuum provides a framework for understanding care experiences in advanced liver disease. Supporting empowerment requires collaborative, accessible, and person-centred approaches involving people with liver disease, carers, and healthcare professionals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17423953261491391","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:09:17Z","timestamp":1791936557000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Empowerment in advanced liver disease: UK experiences of care from the perspectives of people with lived experience, carers and healthcare professionals"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3861-3465","authenticated-orcid":false,"given":"Cathy","family":"Beresford","sequence":"first","affiliation":[{"name":"Bournemouth University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Baron","sequence":"additional","affiliation":[{"name":"Bournemouth University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Dominey","sequence":"additional","affiliation":[{"name":"Lewis-Manning Hospice Care"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Gelling","sequence":"additional","affiliation":[{"name":"Bournemouth University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Gray","sequence":"additional","affiliation":[{"name":"LIVErNORTH trustee, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clement","family":"O'Donovan","sequence":"additional","affiliation":[{"name":"PI contributor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahabuba","family":"Rahman","sequence":"additional","affiliation":[{"name":"PI contributor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Ramshaw","sequence":"additional","affiliation":[{"name":"PI contributor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Williams","sequence":"additional","affiliation":[{"name":"PI contributor, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.03.017"},{"key":"e_1_3_3_3_2","unstructured":"Office for Health Improvement and Disparities. Liver disease profile Liver disease profile - GOV.UK (2025 accessed 11 July 2026)."},{"key":"e_1_3_3_4_2","unstructured":"House of Commons Library. Health inequalities in liver disease and liver cancer https:\/\/researchbriefings.files.parliament.uk\/documents\/CDP-2024-0070\/CDP 2024-0070.pdf (2024 accessed 14 July 2026)."},{"key":"e_1_3_3_5_2","unstructured":"Kimbell B. Living dying and caring in advanced liver disease: the challenge of uncertainty [Thesis]. The University of Edinburgh Living dying and caring in advanced liver disease: the challenge of uncertainty (2014 accessed 16 July 2026)."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.04.026"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2019-0250"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.02.022"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2020.07.017"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro-2023-102431"},{"key":"e_1_3_3_11_2","article-title":"The experiences of people with liver disease of palliative and end-of-life care in the United Kingdom\u2014a systematic literature review and metasynthesis","volume":"27","author":"Beresford CJ","year":"2023","unstructured":"Beresford CJ, Gelling L, Baron S, et al. 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