Rethinking 'risk' and self-management for chronic illness.

Area of Science:

• Healthcare Policy Analysis
• Sociology of Health
• Public Health

Background:

• Current UK healthcare policy emphasizes self-management for chronic illness.
• Policy and clinical guidelines frame chronic illness within a lifestyle risk management discourse.

Purpose of the Study:

• To critique the neoliberal ideology underpinning UK self-management policy.
• To analyze how risk is enacted in policy and its implications for population governance.
• To highlight the limitations of a rational-subject approach to risk management in chronic illness.

Main Methods:

• Critical discourse analysis of UK self-management policy documents.
• Examination of the ideological underpinnings of risk management in healthcare.
• Exploration of lay perspectives on managing chronic illness risk and uncertainty.

Main Results:

• UK self-management policy is deeply intertwined with neoliberal ideology and population governance.
• The dominant policy perspective incorrectly assumes individuals rationally calculate and manage risks.
• Lay individuals face complex, contextual challenges in managing risk, including social roles, emotions, and structural factors.

Conclusions:

• Current self-management policy fails to acknowledge the lived realities and contextual needs of individuals with chronic illness.
• A more holistic approach is needed, moving beyond solely communicating lifestyle risk factors.
• Clinical practice should incorporate a broader understanding of patient needs in self-management.