Disease-specific influences on meaning and significance in self-care decision-making in chronic illness

The purpose of this study was to investigate the everyday self-care decision-making of individuals with chronic illness for the purpose of developing a comparison of decision-making processes between chronic diseases and to identify criteria by which persons with various chronic conditions evaluate the quality of self-care decisions. A sample of 21 individuals with either Type II diabetes, HIV/AIDS, or multiple sclerosis, who were nominated as expert self-care managers by their clinicians, recorded the decisions they made in their daily self-care over a 1-week period and were interviewed in depth to elaborate on the decisions, the processes by which they made them, and the factors that influenced them. This process was repeated to obtain depth and detail in relation to decisions and decision-making processes. The findings revealed that although participants shared similar elements in their self-care decision-making, they differed in the perceived meaning and significance of their decisions, depending on disease-specific attributes relating to timeliness, biomarkers, interaction within a social context, the construction of healthy practices, and available relevant information. Findings were analyzed and compared to suggest future directions for research and educational interventions to enhance the quality of self-care decision-making in chronic illness by considering the influence of disease-specific attributes in self-care management.