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Beyond the realist turn: a socio-material analysis of heart failure self-care.

Author
Abstract
:

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body of HF studies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' in HF self-care. Realist evaluation and realist interventions emphasise that the relationship between self-care interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts of HF self-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advanced HF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influence HF self-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality.

Year of Publication
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2018
Journal
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Sociology of health & illness
Volume
:
40
Issue
:
1
Number of Pages
:
218-233
ISSN Number
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0141-9889
URL
:
http://dx.doi.org/10.1111/1467-9566.12675
DOI
:
10.1111/1467-9566.12675
Short Title
:
Sociol Health Illn
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