The interpretation of self-care: a difference in outlook between clients and home-nurses

In this article, the client's interpretation of self-care and that of home-nurses are compared [1. Agthoven W. M. van and Zorg op Maat. Het afstemmingsproces tussen wijkverpleging, kliënt en informele zorgverlener. Instituut voor Sociale Geneeskunde, Vrije Universiteit (The process of directing self-care, informal and formal assistance). Department of Social Medicine, Free University, Amsterdam, 1985.] Self-care is defined, by two components: the decision (as to) what to do and the execution of the care. In estimating the client's capacity for self-care a limited number of discrepancies play a role on the physical level and many more on the psychosocial level. It is particularly in psychosocial care that a severe distortion occurs if the professional helper makes an estimate of the client's capacity to cope with the psychological and social aspects of care. The client finds himself much more capable, in this respect, than the home-nurse. Moreover, the client estimates the role of this professional helper in providing advice and guidance much lower than the helper in providing advice and guidance much lower than the helper indicates. Various discrepancies in outlook of client and home-nurse concerning self-care were indicated in the study and discussed in relation to Freidsons concept 'social construction of illness' and Scheff's ideas about 'negotiating responsibility'.