| 1. |
- Fex, Angelika, 1955-
(författare)
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Egenvård och medicinsk teknik : Egenvård bland personer med avancerad medicinsk-teknisk utrustning hemma
- 2011
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Ingår i: Nordisk sygeplejeforskning. - Oslo : Universitetsforlaget. - 1892-2678 .- 1892-2686. ; 1:1, s. 66-74
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Tidskriftsartikel (refereegranskat)abstract
- Antalet personer som genomför egenvård med hjälp av avancerad medicinsk-teknisk utrustning hemma ökar. Utrustning för syrgas, dialys och respiratorbehandling är exempel på sådan teknologi. Denna artikel beskriver ett forskningsprojekt som haft till syfte att utveckla kunskap om egenvård och transition, och om faktorer som påverkar dagligt liv och hälsa bland personer som använder avancerad medicinsk-teknisk utrustning hemma. Resultaten från tre kvalitativa delstudier och en kvantitativ delstudie beskrivs, och diskuteras därefter utifrån kliniska implikationer.
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| 2. |
- Fex, Angelika, 1955-
(författare)
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From novice towards self-care expert : studies of self-care among persons using advanced medical technology at home
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The use of advanced medical technology at home has increased in most industrialized countries. The overall aim of this thesis was to develop knowledge of self-care and transition and issues that influence daily life and health among persons using advanced medical technology at home.Three qualitative studies were performed to describe the structure of self-care (I) and elucidate meanings of health-illness transition experiences among persons using long-term oxygen, or a ventila-tor, or performing blood or peritoneal dialysis (II), and to gain a deeper understanding of the meaning of living with an adult family member in this context (III). Ten interviews with adult patients (I-II) and ten with adult next of kin (III) in this context were performed and analysed with descriptive phenome-nological (I), phenomenological hermeneutical (II) and hermeneutical (III) methods. A quantitative, descriptive, comparative, cross-sectional design was used to describe and find factors that influence self-care agency and perceived health in a larger group of persons (180 patients) using the enumerated types of advanced medical technology at home (IV).In the results, (I) self-care among persons using long-term oxygen, a ventilator, or equipment for blood or peritoneal dialysis at home was described at a generic level, independent of the specific type of technology used. The general description of self-care in this context involved prerequisites for, activities for and consequences of self-care; (II) the health-illness transition among adult persons in this context was interpreted as contentment at being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The successful and healthy transition experience was characterized by human growth and becoming; (III) living with a family member who is using advanced medical technology at home was interpreted as meaning rhythmical patterns of being closely connected to but also separated from him or her, and of sorrow versus reconciliation. Dependence on others was reflected in a need for support from the healthcare professionals and significant others; (IV) health-related and technology-related variables in daily life were rated as satisfactory to quite a high extent, but participants using long-term oxygen perceived their health as significantly lower compared to the other technology groups. Further, a significant difference in sense of coherence was found between users of long-term oxygen and peri-toneal dialysis. Factors that contributed to self-care agency and sense of coherence were found.In conclusion, self-care in a high-tech home context means more than simply mastering the technology. With the goal of maintaining an active, social life, the health-illness transition involves a learning process of accepting and integrating the technology into daily life. With knowledge and support, patients and next of kin are able to assume substantial responsibility for self-care/dependent-care. Daily life seems to be manageable for patients using this kind of technology at home.
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| 3. |
- Fex, Angelika, 1955-, et al.
(författare)
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Health–illness transition among persons using advanced medical technology at home
- 2011
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Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell. - 0283-9318 .- 1471-6712. ; 25:2, s. 253-261
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to elucidate meanings of health–illness transition experiences among adult persons using advanced medical technology at home. As an increasing number of persons perform self-care while using different sorts of advanced medical technology at home, knowledge about health–illness transition experiences in this situation may be useful to caregivers in supporting these patients. A qualitative design was used. Five women and five men, all of whom performed self-care at home, either using long-term oxygen therapy from a ventilator or oxygen cylinder, or performing peritoneal or haemodialysis, were interviewed. Ethics committee approval was obtained. Informed consent was received from all participants, and ethical issues concerning their rights in research were raised. The interviews were analysed using a phenomenological hermeneutical methodology, including both an inductive and a deductive structural analysis. This method offers possibilities to obtain an increased understanding by uncovering a deeper meaning of lived experiences through interviews transcribed as texts. The health–illness transition for adult persons in this context was found to mean a learning process of accepting, managing, adjusting and improving daily life with technology, facilitated by realizing the gain from technology at home. Further, the meaning of the health–illness transition experience was interpreted as contentment with being part of the active and conscious process towards transcending into a new state of living, in which the individual and the technology were in tune. The healthy transition experience was characterized by human growth and becoming. This study elucidates one meaning of health–illness transition experiences in relation to the use of advanced medical technology on a more generic level, independent of the specific type of technology used. A positive attitude towards technology at home facilitates the transition.
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| 4. |
- Fex, Angelika, 1955-, et al.
(författare)
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Living with an adult family member using advanced medical technology at home
- 2011
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Ingår i: Nursing Inquiry. - : Wiley. - 1320-7881 .- 1440-1800. ; 18:4, s. 336-347
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Living with an adult family member using advanced medical technology at home An increased number of chronically ill adults perform self-care while using different sorts of advanced medical technology at home. This hermeneutical study aimed to gain a deeper understanding of the meaning of living with an adult family member using advanced medical technology at home. Eleven next of kin to adults performing self-care at home, either using long-term oxygen from a cylinder or ventilator, or performing peritoneal or haemodialysis, were interviewed. The qualitative interviews were analysed using a Gadamerian methodology. The main interpretation explained the meaning as rhythmical patterns of connectedness versus separation, and of sorrow versus reconciliation. Dependence on others was shown in the need for support from healthcare professionals and significant others. In conclusion, next of kin took considerable responsibility for dependent-care. All next of kin were positive to the idea of bringing the technology home, even though their own needs receded into the background, while focusing on the best for the patient. The results were discussed in relation to dependent-care and transition, which may have an influence on the self-care of next of kin and patients. The study revealed a need for further nursing attention to next of kin in this context.
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| 5. |
- Fex, Angelika, 1955-, et al.
(författare)
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Self-care agency and perceived health among people using advanced medical technology at home
- 2012
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 68:4, s. 806-815
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Tidskriftsartikel (refereegranskat)abstract
- Aim.This article reports a study of self-care agency and perceived health in a groupof people using advanced medical technology at home. Background.An increasing number of people are using medical technology for selfcare.Few studies describe daily life in this context at an overriding level, irrespectiveof the specific sort of technology. A connection between self-care, perceived healthand sense of coherence has previously been implied. Methods.A descriptive, comparative, cross-sectional quantitative design was used.Data were collected from a questionnaire during the winter of 2009/2010. Thequestionnaire addressed perceived health and daily life with medical technology.Swedish versions of the Appraisal of Self-care Agency scale and the 13-item versionof Antonovsky’s sense of coherence scale were included. Results.The questionnaire was answered by 180 adults performing self-care athome involving long-term oxygen, a ventilator, or peritoneal- or haemo-dialysis.Health-related and technology-related variables in daily life were mostly highlysatisfactory. Perceived health was rated significantly lower among participants usinglong-term oxygen. Sufficient sense of coherence, knowledge of how to use technology,close contact with others and not feeling helpless contributed positively toself-care agency. Positive contributing factors for perceived health were being satisfiedwith life, having an active life and not feeling helpless, whereas age was anegative factor. Conclusion.Daily life is manageable for people in this context. Long-term oxygentreatment and advanced age can be regarded as risk factors for perceiving ill health.
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| 6. |
- Fex, Angelika, 1955-, et al.
(författare)
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Self-Care Agency and Perceived Health Among Persons Using Advanced Medical Technology at Home
- 2012
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 68:4, s. 806-815
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper is a report of a study of self-care agency and perceived health in a group ofpersons using advanced medical technology at home.Background. An increasing number of persons are using medical technology for self-care. Few studies describe daily life in this context at an overriding level, irrespective of the specific sort of technology. A connection between self-care, perceived health and sense of coherence has previous been implied.Methods. A descriptive, comparative, cross-sectional quantitative design was used. Data were collected from a questionnaire in the winter 2009/2010. The questionnaire addressed perceiveed health and daily life with medical technology, and applied Swedish versions of the Appraisal of Self-care Agency scale and the 13-item version of Antonovsky’s sense of coherence scale.Results. The questionnaire was answered by 180 adults performing self-care at home involving long-term oxygen, a ventilator, peritoneal or blood dialysis. Health-related and technology-related variables in daily life were rated as satisfactory to a high extent. Perceived health was rated significantly lower among participants using long-term oxygen. Sufficient sense of coherence and knowledge of how to use technology, close contacts with other persons, and not feeling helpless contributed positively as factors for self-care agency. Positive factors for perceived health were being satisfied with life, having an active life, and not feeling helpless, while age was a negative factor.Conclusion. Daily life is manageable for persons using these types of technology. Long-term oxygen treatment and advanced age can be seen as risk factors for perceiving ill health.
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