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The shifting perspectives model of chronic illness
1University of British Columbia School of Nursing, T201-2211 Wesbrook Mall, Vancouver, BC, Canada V6T 2B5. paterson@nursing.ubc.ca
Purpose:
To present the Shifting Perspectives Model of Chronic Illness, which was derived from a metasynthesis of 292 qualitative research studies.
Design:
The model was derived from a metasynthesis of qualitative research about the reported experiences of adults with a chronic illness. The 292 primary research studies included a variety of interpretive research methods and were conducted by researchers from numerous countries and disciplines.
Methods:
Metastudy, a metasynthesis method developed by the author in collaboration with six other researchers consisted of three analytic components (meta-data-analysis, metamethod, and metatheory), followed by a synthesis component in which new knowledge about the phenomenon was generated from the findings.
Findings:
Many of the assumptions that underlie previous models, such as a single, linear trajectory of living with a chronic disease, were challenged. The Shifting Perspectives Model indicated that living with chronic illness was an ongoing and continually shifting process in which an illness-in-the-foreground or wellness-in-the-foreground perspective has specific functions in the person's world.
Conclusions:
The Shifting Perspectives Model helps users provide an explanation of chronically ill persons' variations in their attention to symptoms over time, sometimes in ways that seem ill-advised or even harmful to their health. The model also indicates direction to health professionals about supporting people with chronic illness.