| 1. |
- Lönnstedt, Minna, et al.
(författare)
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Living with long-lasting pain : patients’ experiences of neuropathic pain
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley-Blackwell. - 1752-9816 .- 1752-9824. ; 3:4, s. 469-475
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this study was to describe the lived experiences of patients with neuropathic pain.Background. An estimated 132 000 (1·5%) Swedes are affected by some form of neuropathic pain, but the exact prevalence is uncertain. Neuropathic pain is a syndrome that is often under-diagnosed. Earlier studies focusing on the experience of neuropathic pain show that it has a huge impact on life and that pain-related limitations result in social withdrawal.Conclusions. The present study contributes to nursing knowledge by presenting a picture of living with neuropathic pain. It confirms earlier data which found that living with neuropathic pain often brings major changes in a person’s way of life, influencing daily activities and social life. The findings indicate the importance of being met with empathy and a positive attitude from healthcare professionals and pointed out the negative impact on a patient’s trust when healthcare professionals question them about the pain. The findings confirm that feelings of loneliness and vulnerability emerged when patients were not met with trust.Relevance for clinical practice. The findings are clinically relevant for nurses and other healthcare professionals, because they provide information on the patients’ symptoms and the strategies they use to deal with neuropathic pain on a daily basis. The current study indicates that more attention must be placed on the healthcare professionals’ attitude when meeting patients living with neuropathic pain. The findings highlight that professional and positive encounters between healthcare staff and patients should be emphasised, as a part of nursing education and in clinical practice, as this has a profound effect on the patient’s trust in care.
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| 2. |
- Audulv, Åsa, 1980-, et al.
(författare)
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An ongoing process of inner negotiation – a Grounded Theory study of self-management among people living with chronic illness
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 1:4, s. 283-293
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this study was to better understand the main concern of self-management processes among people with chronic illness.Background. One aspect of living with chronic illness is self-management that can reduce the illness impact on daily life and promote future health. Although factors that influence self-management have been identified in previous research, little attention has been brought to the process of making self-management decisions. In clinical settings, use of a theory could facilitate patient-empowering approaches.Method. The data collection for this Grounded Theory was mostly conducted in 2006. Data were collected by interviews with 26 adults with a variety of chronic illnesses, including rheumatoid arthritis, diabetes mellitus, inflammatory bowel syndrome, multiple sclerosis, ischaemic heart disease and chronic kidney failure.Results. Individuals are conflicted by competing preferences when taking decisions about self-management. Consequently, the decision-making process can be understood as an ongoing inner negotiation between different incompatible perspectives, e.g. social needs vs. medical needs. The process of negotiating self-management starts with the individual’s considering beliefs about health and illness, which make the individual face illness threats and the need for self-management. Several aspects influence negotiating self-management namely, assessing effects of self-management; evaluating own capacity; perceiving normality or stigmatisation; and experiencing support and external resources. The process has been demonstrated in a model.Conclusions. The process of negotiating self-management is an ongoing inner debate rather than a one-time decision. This opens up new ways of understanding, and communicating with, patients. The described model also links behavioural theories and research findings in a comprehensive understanding.Relevance to clinical practice. This model could be applicable as a communication tool for health-care providers in identifying barriers to, and resources in, self-management behaviour among individuals with chronic illness.
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| 3. |
- Björklund, Margereth, 1950-, et al.
(författare)
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Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer. Background. Head and neck cancer has a profound and chronic impact on the individual's everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual's health. Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed. Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one's illness story; having a working relationship with health professionals and receiving individualised, tailored care. Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient's lifeworld in relation to health, illness and suffering and focusing on the individual's personal strengths and health resources. Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 4. |
- Björklund, Margereth, et al.
(författare)
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Health promoting contacts as encountered by individuals with head and neck cancer
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 1:3, s. 261-268
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the characteristics of health promoting contacts with health professionals as encountered by individuals with head and neck cancer.Background. Head and neck cancer has a profound and chronic impact on the individual’s everyday life, e.g. physical problems that hinder speaking, breathing, eating and drinking. Furthermore, fear and uncertainty can lead to long-term psychological and psychosocial problems. The National Institute of Public Health in Sweden advocates that all care contacts should improve the quality of the individual’s health.Design. A qualitative descriptive and explorative design was used. Eight participants were interviewed in the year 2005 and a qualitative thematic content analysis of the data was performed.Findings. Health promoting contacts were defined as contacts where health care professionals contribute positively to the well-being of individual patients. Characteristics include being available, engaged, respectful and validating. Three themes were identified: being believed in one’s illness story; having a working relationship with health professionals and receiving individualised, tailored care.Conclusions. Health promoting contacts were experienced mainly during the treatment phase, when patients had daily contact with specific, qualified health professionals. Although the interview questions focused on health promoting contacts, nearly half of the contacts were experienced as not health promoting. Feelings of abandonment were particularly manifested before and after treatment. The starting point for achieving health promoting contact lies in understanding the patient’s lifeworld in relation to health, illness and suffering and focusing on the individual’s personal strengths and health resources.Relevance to clinical practice. The findings highlighted the importance of ensuring that patient interests and concerns are core considerations in health care. The participants viewed continuing individualised, tailored care and access to ear, nose and throat healthcare professionals as highly important.
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| 5. |
- Hajdarevic, Senada, et al.
(författare)
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Patients' decision making in seeking care for suspected malignant melanoma
- 2010
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley-Blackwell. - 1752-9816 .- 1752-9824. ; 2:2, s. 164-173
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore patients' decision making about seeking care for malignant melanoma (MM).Background. Unlike other cancers, MM is generally visible and can be easily and cheaply cured if treated in time. It is the delay in diagnosis, most often attributable to the patient rather than to care providers, that results in mortality. Self-examination of suspicious lesions is important, but it is not a guarantee of immediate care-seeking, nor is early detection and increased melanoma awareness associated with early care-seeking.Method. During 2009, men (n = 10) and women (n = 11) diagnosed with malignant melanoma were interviewed within two years after excision and the text was analysed according to Grounded Theory.Results. The perception of a critical level of severity, feelings of fear and threat were found to be a key motivator for patients to seek care for suspected melanomas; as soon as sufficient insight into the severity of the disease was achieved, the patient reached a turning point and sought care immediately.Conclusions. Most of the participants described the process from the discovery of the lesion to the decision to seek care as a time-consuming inner negotiation about the severity of the disease, personal and social considerations, and interactions with the healthcare system.Relevance to clinical practice. We analysed the complex reasoning of the patients leading up to the turning point when they sought care. This study illustrates for caregivers the importance of simplifying the pathways to care, emphasising the seriousness of MM, and taking worried patients seriously from their first contact with health care. Health professionals, through their attitudes in contact with patients, can either facilitate or obstruct the patient's decision making process.
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| 6. |
- Hjelmblink, Finn, et al.
(författare)
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The meaning of rehabilitation for older people who have survived stroke
- 2009
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 1:2, s. 186-195
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore the meaning of rehabilitation to older, Swedish stroke survivors, from the time of the acute stroke to the end of the rehabilitation. Background. Many people who are stroke survivors do not resume social activities even though they have regained physical functions. However, the contents of stroke rehabilitation seems to depend on whether rehabilitation is understood from the disease perspective or the illness perspective contained in the International Classification of Functioning, Disability and Health. This in turn may determine the kind of rehabilitation offered to survivors. Design. Inductive, qualitative interview study undertaken during 2003. Method. Nineteen Swedish stroke survivors were interviewed twice, and the interviews were analysed using a Grounded Theory approach. Findings. To the older survivors, the meaning of rehabilitation was social reintegration. To achieve this they tried to regain lost physical and cognitive functions, relations (including play activities, everyday narratives and self-esteem) and lost certainty. The survivors needed to regain their ability to be not only to perform social activities. However, their rehabilitation ended when its focus turned to impairments found in the illness experiences of the survivors. The survivors developed their own cognitive and behavioural strategies for overcoming these kinds of obstacles to their social reintegration. Conclusion. Older, Swedish stroke survivors strive for a socially integrated life. Unacknowledged impairments experienced from the illness perspective of the survivors and the survivors’ own rehabilitation strategies should therefore be considered in their rehabilitation. Relevance to clinical practice. Stroke survivors need support from professionals who can understand and acknowledge the illness perspective of rehabilitation. Professionals should be able to understand how to facilitate the cognitive and behavioural strategies found in survivors’ illness narratives. In order to socially reintegrate, survivors’ rehabilitation should be transferred to the places where they have previously performed play activities together with family and friends.
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| 7. |
- Hörnsten, Åsa, et al.
(författare)
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A model of integration of illness and self-management in type 2 diabetes
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Singapore : Wiley-Blackwell. - 1752-9816 .- 1752-9824. ; 3:1, s. 41-51
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To describe the process of illness integration and self-management among people with type 2 diabetes.Background. Integration of illness is a developmental process referring to the emotional and existential aspects of being ill. It is an overarching concept that describes the process that a person undergoes in living with a chronic disease, from prediagnosis to adaptation to illness as a natural part of life. Despite the common use of terms such as illness integration and self-management, there exists little research that investigates how these concepts relate to one another.Methods. A narrative interview study applying qualitative content analysis was conducted with people diagnosed with type 2 diabetes. The study focused on their personal understandings of illness, and particularly, the relationship of the participants’ illness integration to self-management of the disease. Data were collected in 2002.Results. In the trajectory from prediagnosis to adaptation, there is a turning point when people seem to integrate the illness emotionally and existentially, and in relation to their self-management practice. The trajectory includes the phases of suspecting illness/being diagnosed, understanding and explaining the illness, and negotiating illness and taking stands about self-management. These phases in turn are influenced by perceptions of the seriousness and threat of the disease; the intensity and nature of the ill person’s emotional response to the disease and its management; goals and expectations for living with the disease and for living in general; and lastly, perceptions of the outcomes and impacts of self-management.Conclusion. Illness integration and self-management processes develop simultaneously. In some cases, a turning point occurs that causes the person to view self-management as both necessary and feasible.Relevance to clinical practice. Nurses may influence the illness integration trajectory and assist people with type 2 diabetes to integrate the disease and its management more readily.
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| 8. |
- Lundberg, Pranee C., et al.
(författare)
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Diabetes type 2 self-management among Thai Muslim women
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - : Wiley. - 1752-9816 .- 1752-9824. ; 3:1, s. 52-60
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Tidskriftsartikel (refereegranskat)abstract
- Aim To explore and describe Thai Muslim women’s self-management of diabetes type 2. Background The importance of diabetes self-management is well recognised. However, research on diabetes self-management in Thailand is limited, and no such research related to Muslim patients with diabetes type 2 has been found. Methods An explorative qualitative study using ethnography was conducted. The ethnographic method was based on qualitative interview and participant observation carried out in 2008. Orem’s self-care deficit nursing theory provided the theoretical framework. Purposive convenience sampling was used, and twenty-nine women aged 40–80 years participated. Results Four themes of self-management among Thai Muslim women with diabetes type 2 emerged, viz., daily life practices (dietary management, exercise, use of medicine, see doctor to follow-up, self-monitoring of blood sugar and use of herbal remedies), impact of the illness (feeling psychological burden of diabetes and struggling to control the disease), everyday life as before (maintaining religious practices and learning to live with the disease) and family support. Conclusion The Thai Muslim women suffered from a partial self-care deficit. The results underline the importance of taking religious traditions into account in the care, offering health education that helps patients cope with their disease, involving family members who can reinforce information given to patients, and increasing self-management power and capability of patients. Relevance to clinical practice When caring for Thai Muslim women with diabetes type 2, health care professionals should stimulate their patients to adopt a powerful strategy for modifying their daily life behaviour, and they should be aware of the existence of certain problematic behaviour of their patients. It is also important that they understand the roles of cultural background, religious tradition and family as parts of the basis for educational strategies aimed at helping patients successfully integrate disease management into their lives.
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| 9. |
- Roos, Susanne, et al.
(författare)
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Bowel symptoms, self-image and comorbidity impact on well-being of women with coeliac disease
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Oxford : Wiley-Blackwell. - 1752-9816 .- 1752-9824. ; 3:3, s. 302-309
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore if gastrointestinal (GI) symptoms, self-image and comorbidity are related to well-being in women with coeliac disease (CD) and whether a history of CD in childhood impacts on well-being in adulthood. Background. Women in Sweden living with CD show a reduced level of well-being and report a high rate of GI complaints for unclear reasons. The self-image of these women is unknown. Design. A cross-sectional survey of 231 Swedish women with CD on long-term treatment (≥5 years) with a gluten-free diet (GFD) was conducted in 2010. Results. The study showed that well-being is related to a high rate GI symptoms (OR 16·9, 95% CI 5·6-50·7), a negative self-image (OR 8·9, 95% CI 3·5-22·9) and comorbidity (OR 3·3, 95% CI 1·7-6·4). There was no impact of childhood symptoms on well-being, GI symptoms, self-image or comorbidity in adulthood. Half of the study population showed reduced well-being compared with norms. Practically all women (97%) declared that they were always or usually following a GFD and 62% reported at least one disease besides CD. Conclusion. The study demonstrated that the well-being of women living with CD is affected by GI complaints, self-image and a high rate of comorbidity whereas a history of signs and symptoms of CD in childhood not seems to impact on the well-being in adulthood. Relevance to clinical practice. Gastrointestinal symptoms, self-image and comorbidity are factors contributing to a low level of well-being of CD women living on a GFD. Launching a multi-disciplinary team for follow-up would represent a novel approach to support these women and may prove valuable in improving their subjective health.
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| 10. |
- Audulv, Åsa, 1980-, et al.
(författare)
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The influence of illness perspectives on self-management of chronic disease
- 2011
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Ingår i: Journal of Nursing and Healthcare of Chronic Illness. - Singapore : Blackwell Publishing Ltd. - 1752-9816 .- 1752-9824. ; 3:2, s. 109-118
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To explore people’s illness perspectives and related self-management of chronic disease.Background: Individuals’ illness beliefs and perspectives have been suggested to influence their self-management behaviour. However, research that has examined the influence of illness perspectives on chronic disease self-management has been largely quantitative and has focused on selected elements of self-management. How individuals’ illness perspectives influence their whole of self-management has not been investigated in depth.Method: The phenomenographic research study entailed 26 narrative interviews with Swedish adults with a variety of chronic diseases. Data were collected mostly during 2006.Results: The participants described two illness perspectives; being life-oriented meant to focus upon how to live a good life with disease, whereas a diseaseoriented illness perspective emphasised the medical and physiological aspects of disease. The participants attested to one of the two illness perspectives as a main perspective, although they shifted between the perspectives depending of context and illness experience. The participants’ illness perspectives were reflected in their understandings of self-management. Participants with a dominant life-oriented illness perspective performed self-management in order to continue living a ‘normal’ life (e.g. facilitate activity and mental well-being). When holding a disease-oriented illness perspective, self-management was focused upon controlling disease (e.g. symptom management and avoiding disease related complications).Conclusions: People with chronic illness hold a dominant illness perspective that determines how they understand and enact self-management. These perspectives 2011 Blackwell Publishing Ltd 109 are not static; instead individuals tend to shift between the perspectives under specific circumstances.Relevance to clinical practice: Health-care providers shall acknowledge that individuals’ with chronic illness shift between a life-oriented and a disease-oriented illness perspective. The results of the current study can be used by health-care providers in order to launch a dialogue in order to support individuals’ self-management.
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