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dc.contributor.authorArrieta Valero, Ion
dc.date.accessioned2020-01-08T13:17:25Z
dc.date.available2020-01-08T13:17:25Z
dc.date.issued2019-08-14
dc.identifier.citationFrontiers in Psychology 10 : (2019) // Article ID 1857es_ES
dc.identifier.issn1664-1078
dc.identifier.urihttp://hdl.handle.net/10810/37523
dc.description.abstractIn recent years, several studies have advocated the need to expand the concept of patient autonomy beyond the capacity to deliberate and make decisions regarding a specific medical intervention or treatment (decision-making or decisional autonomy). Arguing along the same lines, this paper proposes a multidimensional concept of patient autonomy (decisional, executive, functional, informative, and narrative) and argues that determining the specific aspect of autonomy affected is the first step toward protecting or promoting (and respecting) patient autonomy. These different manifestations of autonomy are not mutually dependent; there may be patients who have problems in one dimension, while at the same time being fully autonomous in others. Nevertheless, a close interaction has been observed between the various dimensions, and indeed, a phenomenological analysis shows that damage to or a reduction in one aspect of people's capacity for self-government generally affects other aspects of their autonomy, which in turn disrupts their identity and the way in which they see themselves and are seen by others. In this paper, I shall examine some of these interactions and show how they may lie at the heart of the problem of poor treatment adherence in many patients with chronic ailments (where adherence is defined as being the extent to which a patient's behavior over time coincides with the recommendations made by and agreed with their health professional). One example given is that of psoriasis, a chronic skin disease with a very poor adherence record. In Spain, it is calculated that 85% of patients diagnosed with mild to moderate psoriasis fail to comply properly with their treatment, and figures from other parts of the world are similar. Although there are many possible causes for non-adherence among psoriasis patients, assessing their decisional, executive, and narrative capacities and taking appropriate action based on the results may help increase adherence rates.es_ES
dc.description.sponsorshipThis paper forms part of the project "Psoriasis y autonomia ejecutiva. Una propuesta de mejora de la adherencia de los pacientes al tratamiento de la psoriasis" (Psoriasis and executive autonomy. A proposal for improving patients' adherence to treatment for psoriasis), financed with a grant from the Fundacio Victor Grifols i Lucas (2017-2018) (https://www.fundaciogrifols.org/en/web/fundacio/home). This work was also funded by the research project entitled "Identidad en interaccion: Aspectos ontologicos y normativos de la individualidad biologica, cognitiva y social," reference: FFI2014-52173-P, funded by the Ministry of Economy and Competition of Spain.es_ES
dc.language.isoenges_ES
dc.publisherFrontiers Mediaes_ES
dc.relationinfo:eu-repo/grantAgreement/MINECO/FFI2014-52173-Pes_ES
dc.rightsinfo:eu-repo/semantics/openAccesses_ES
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/es/*
dc.subjectpatient autonomyes_ES
dc.subjectdecisional autonomyes_ES
dc.subjectexecutive autonomyes_ES
dc.subjectnarrative autonomyes_ES
dc.subjectcapacityes_ES
dc.subjectidentityes_ES
dc.subjectadherence to treatmentes_ES
dc.subjectpsoriasises_ES
dc.subjectphysicianses_ES
dc.titleAutonomies in Interaction: Dimensions of Patient Autonomy and Non-adherence to Treatmentes_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.rights.holder© 2019 Arrieta Valero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.es_ES
dc.rights.holderAtribución 3.0 España*
dc.relation.publisherversionhttps://www.frontiersin.org/articles/10.3389/fpsyg.2019.01857/fulles_ES
dc.identifier.doi10.3389/fpsyg.2019.01857
dc.departamentoesFilosofíaes_ES
dc.departamentoeuFilosofiaes_ES


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© 2019 Arrieta Valero. This is an open-access article distributed under
the terms of the Creative Commons Attribution License (CC BY). The use, distribution
or reproduction in other forums is permitted, provided the original author(s) and
the copyright owner(s) are credited and that the original publication in this journal
is cited, in accordance with accepted academic practice. No use, distribution or
reproduction is permitted which does not comply with these terms.
Except where otherwise noted, this item's license is described as © 2019 Arrieta Valero. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.