Normalization Process Theory Coding Frame for the Treatment Burden of Chronic Heart Failure
| Coherence (Sense-Making Work)a | Cognitive Participation (Relationship Work)b | Collective Action (Enacting Work)c | Reflexive Monitoring (Appraisal Work)d |
|---|---|---|---|
| Note: In each cell, the first entry is the subcomponent, followed by the description. | |||
| a Understanding the prospect of having chronic heart failure, what it means, and how the condition may be managed. | |||
| b Investing personal and interpersonal commitment to living with the condition and its management. | |||
| c Investing effort and resources in management, carrying out tasks, and experiencing the Illness. | |||
| d Reflecting on the effects of therapies in retrospect and determining whether to modify them. | |||
| Differentiation: understanding and differentiating between aspects of the illness, tests, treatments, and the roles of different health professionals | Enrollment: engaging with friends, family, and health professionals with regards to the illness and its management to enable them to provide support | Skill set workability: setting a routine/strategy to cope with symptoms, exacerbations, and emergency situations, that is therapeutic interventions and self-monitoring | Reconfiguration: altering a set routine when required, such as medication regimens or appointments, to fit in with daily activities or other arrangements |
| Communal specification: gaining information about the illness and its management with the help of others, for example, friends, family, or health professionals | Activation: arranging help (eg, logistical, administrative, or expert) from health professionals, social services, or friends and family | Contextual integration: making sure you have the right financial and social resources, and integrating the illness into social circumstances | Communal appraisal: discussing or altering current management plans already initiated, in discussion with health professionals or friends and family |
| Individual specification: achieving your own understanding of the illness and its management in personal terms, through personal research such as reading, or personal life experience | Initiation: using organizational skills to arrange one’s own contribution to management, such as arranging prescriptions, social care, and transport to appointments | Interactional workability: taking treatments, enacting lifestyle changes, attending appointments, enduring symptoms and side effects | Individual appraisal: assessing individually whether to continue or alter current management plans |
| Internalization: relating your experience to the illness and its treatment, understanding its implications, knowing when to seek help | Legitimation: seeking reassurance about treatments from others about appropriate- ness of management plans | Relational integration: developing relationships with and confidence in health professionals and their interaction with each other; overcoming barriers in accessing care | Systematization: developing ways of keeping up to date with newly available treatments |