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dc.contributor.authorAhlsen, Birgitte
dc.contributor.authorEngebretsen, Eivind
dc.contributor.authorNicholls, David
dc.contributor.authorMengshoel, Anne Marit
dc.date.accessioned2019-04-08T12:29:52Z
dc.date.accessioned2019-04-09T06:50:17Z
dc.date.available2019-04-08T12:29:52Z
dc.date.available2019-04-09T06:50:17Z
dc.date.issued2019-03-27
dc.identifier.citationAhlsen B, Engebretsen E, Nicholls D, Mengshoel AM. The singular patient in patient-centred care. Physiotherapists' accounts of treatment of patients with chronic muscle pain. Medical Humanities. 2019en
dc.identifier.issn1468-215X
dc.identifier.issn1468-215X
dc.identifier.issn1473-4265
dc.identifier.urihttps://hdl.handle.net/10642/6937
dc.description.abstractA patient-centered approach has gained increasing interest in medicine and other health sciences. Whereas there are discussions about the meaning of a patientcentered approach and what the concept entails, little is known about how the patient as a person is understood in patient-centered care. This mticle investigates understandings of the patient as a self in patient-centered care through physiotherapy of patients with chronic muscle pain. The material consists of interviews with five Norwegian physiotherapists working in a rehabilitation clinic. Drawing on Kristeva's discussion of subjectivity in medical discourse, the study highlights two different treatment storylines that were closely entwined. One storyline focuses on open singular healing processes in which the treatment was based on openness to a search for meaning and sharing. In this storyline, the "person" at the center of care was not essentialized in terms of \ i biological mechanisms, but rather considered as a vulnerable, in-ational and moving self. By contrast, the second storyline focused on goal-oriented interventions aimed at restoring the patient to health. Here, the person in the center of the treatment was shaped according to model narratives about "the successful patient"; the empowered, rational, choosing and self-managing individual. As such, the findings revealed two conflicting concepts of the individual patient inherent in patientcentered care. On the one hand, the patient is seen as being a person in constant movement, and on the other, they are captured by more standardized te1ms designed to focus on more stable notion of outcome of illness. Therefore, our study suggests that the therapists' will to recognize the individual in patient-centered care had a counterpmt involving a marginalization of the singular.en
dc.description.sponsorshipThe Norwegian Fund for Post-Graduate Training in Physiotherapy gave financial support.en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.ispartofseriesMedical Humanities;
dc.rightsThis article has been accepted for publication in Medical Humanities, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/medhum-2018-011603. © Author(s) (or their employer(s)) 2019. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/.
dc.subjectPhysiotherapistsen
dc.subjectHealth care educationen
dc.subjectHealth care philosophiesen
dc.subjectMedicine philosophyen
dc.titleThe singular patient in patient-centred care. Physiotherapists' accounts of treatment of patients with chronic muscle painen
dc.typeJournal articleen
dc.typePeer revieweden
dc.date.updated2019-04-08T12:29:52Z
dc.description.versionacceptedVersionen
dc.identifier.doihttp://dx.doi.org/10.1136/medhum-2018-011603
dc.identifier.cristin1688409
dc.source.journalMedical Humanities


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This article has been accepted for publication in Medical Humanities, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/medhum-2018-011603. 
© Author(s) (or their employer(s)) 2019. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons
Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/.
Except where otherwise noted, this item's license is described as This article has been accepted for publication in Medical Humanities, 2019 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/medhum-2018-011603. © Author(s) (or their employer(s)) 2019. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where a another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC-BY-NC 4.0) https://creativecommons.org/licenses/by-nc/4.0/.