Background Patient and family empowerment strategies have increased patients’ abilities to manage their disease, adopt healthier behaviours, and use health services more effectively, as well as increasing care-giver coping skills and efficacy (1). However, rheumatic patient’s ability to perform self-care practices (2) is frequently threatened by disease flare and disability, both contributing for questioning the patients’ power to control their illness and their own lives.

Objectives This paper aims to explore the concepts of patient agency, empowerment and self-management, also discussing the patients’ perspectives on compliance and adherence. It will approach the impacts of self management on well-being, considering illness characteristics, patients’ dilemas and family life.

Methods By reviewing some literature on patients’ agency, empowerment and self-management, and illness narratives, this paper proposes a reflection upon patient-centered health care.

Results Returning to the issue of the impacts of autoimmune diseases on the “self”, the sense of conflict between human agency and the disease ethiology can compromise the patient’s agency regarding health promoting behaviours and self-management.

1. Wallerstein N (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen,WHO Regional Office for Europe (Health Evidence Network report; http://www.euro.who.int/Document/E88086.pdf, accessed 01 February 2006)

2. Cutler, Carol (2003). Assessing patients’ perception of self-care agency in Psychiatric Care. Issues in Mental Health Nursing, 24:199–211.

Disclosure of Interest None Declared