J Haem Pract 2016; 3(2):1 - 3. doi: 10.17225/jhp00079

Authors: Kam A McIntosh

Kam A McIntosh
Patient/Nurse Educator, British Columbia Provincial Bleeding Disorders Program – Adult Division, Burrard Building, Room 491 St. Paul’s Hospital, 1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6. E-mail:


This case describes a young man with severe haemophilia B who uses the “avoiding” mode of behaviour, leading to isolation and reduced ambulation. Health care providers promoting health change behaviour were able to empower the patient to direct his care toward his desired outcomes. As his self-awareness increases, he begins to use another mode of behaviour: compromising. Thomas-Kilmann’s conflict management framework is a novel approach to bringing two sides together in a working partnership. This challenging case shows the balance between a patient’s self-care and symbiotic interaction with HCPs to achieve successful health outcomes.


The author wishes to thank Dr Shannon Jackson and Dr Linda Sun for their assistance




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The Journal of Haemophilia Practice is published by Haemnet.

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