Chronic diseases are defined as illnesses that are prolonged, do not resolve spontaneously and are rarely cured. They constitute 46% of the global burden of diseases and are responsible for 59% of deaths in Canada, tallying billions of dollars in annual medical expenditures. Regardless of the variety of available treatments, a vast majority of patients with chronic conditions report they do not receive the care they need or expect. The efficacy of chronic disease management (CDM) has been proven effective for the general population; the focus of this paper, however, is around populations who are less responsive to mainstream behaviour change interventions. Alternative conceptualizations of CDM could lend support for the development of models that target hard-to-reach populations who often have complex needs and for who typical interventions are reported to be less effective. This paper will explore two theoretical perspectives which provide the basis for alternative conceptualizations, symbolic interactionism (SI) and institutional ethnography (IE).


Chronic Disease Management, Public Health, Conceptualizations, Interpretivism, Critical Social Theory

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