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- Afrell, Maria, et al.
(författare)
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Living with a body in pain – between acceptance and denial
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 21:3, s. 291-296
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Tidskriftsartikel (refereegranskat)abstract
- The aetiology of nonspecific musculoskeletal pain is considered to be multi-factorial. Long-standing pain not only has a negative impact on the individual's general health but also changes the individual's experience of him/her self and his/her world. The aim of this study was to describe how individuals with long-standing musculoskeletal pain, in a bodily existential perspective, relate to their aching body. Semi-structured interviews with 20 patients were analysed using mainly a phenomenological-hermeneutic method. From the analysis, four main categories reflect the meaning contents of the interviews: the body as an aspect of identity; body reliance; body awareness; ways of understanding pain. From these categories, four distinct typologies were inferred: surrendering to ones fate; accepting by an active process of change; balancing between hope and resignation; rejecting the body. The result indicates that patients with long-standing pain are to be found along a spectrum from accepting to rejecting the aching body. Body awareness and body reliance seem to have importance in the process of acceptance of the body as well as life situation as a whole, which we regard as interesting hypotheses for further inquiry.
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| 4. |
- Berman, Anne H., et al.
(författare)
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Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC) : A Qualitative and Quantitative Analysis of Participants' Perceptions
- 2017
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Ingår i: Academic Psychiatry. - : Springer Science and Business Media LLC. - 1042-9670 .- 1545-7230. ; 41:5, s. 631-641
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Tidskriftsartikel (refereegranskat)abstract
- Objective The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas. Methods A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively. Results In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients. Conclusions Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.
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| 6. |
- Biguet, Gabriele, et al.
(författare)
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Meanings of "acceptance" for patients with long-term pain when starting rehabilitation
- 2016
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 38:13, s. 1257-1267
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The study aimed to elucidate the meaning of acceptance in relation to the lived body and sense of self when entering a pain rehabilitation programme.METHODS: Six women and three men with long-term pain were interviewed. The interviews were analysed according to interpretative phenomenological analysis.RESULTS: The analysis revealed three different meaning structures, first: acceptance as a process of personal empowerment, "the only way forward". Here, the individuals expressed that the body felt integrated: a trusting cooperation between self and body gave rise to hope. Second: acceptance as an equivocal project, a possible but challenging way forward. The hopeful insight was there, acknowledging that acceptance was the way to move forward, but there was also uncertainty and doubt about one's ability with a body ambiguous and confusing, difficult but important to understand. Third, in acceptance as a threat and a personal failure, "no way forward" the integration of the aching body in sense of self was impossible and pain was incomprehensible, unacceptable and unfair. Pain was the cause of feeling stuck in the body, affecting the sense of self and the person's entire life.CONCLUSIONS: The meaning of acceptance was related to acceptance of the persistency of pain, to how the individual related to the lived body and the need for changes in core aspects of self, and to the issue of whether to include others in the struggle of learning to move on with a meaningful life. Implications for Rehabilitation Healthcare professionals should be aware that individuals with long-term pain conceptualize and hold different meanings of acceptance when starting rehabilitation; this should be considered and addressed in rehabilitation programmes. The meaning given to acceptance is related to the experience of the lived body and the sense of self, as well as to getting legitimization/acceptance by others; therefore these aspects need to be considered during rehabilitation. The process of achieving acceptance seems to embrace different processes which can be understood as, and facilitated by, an embodied learning process. The bodily existential challenges presented in the present study, for example to develop an integrated and cooperative relationship with the painful body, can inspire health professionals to develop interventions and communication strategies focusing on the lived body. A wide range of competencies in rehabilitation clinics seems to be needed.
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| 7. |
- Biguet, Gabriele
(författare)
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The meaning of acceptance and body awareness for individuals living with long-term pain : implications for rehabilitation
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Chronic or long-term pain, usually defined as pain lasting at least three to six months, is generally understood as a multidimensional phenomenon, often requiring a multidisciplinary rehabilitation approach. The aetiology of longterm musculoskeletal pain is considered to be multi-factorial. Although body awareness treatment approaches and acceptance-based methods are incorporated in pain rehabilitation, there is still a need for knowledge as to how they contribute to the process of change in rehabilitation. Both body awareness and acceptance are multi-dimensional concept. Aims: The aims of the thesis were to describe how individuals with long-term musculoskeletal pain experience and relate to (a) their aching body (Study I), (b) body awareness as a resource in rehabilitation (Study II). A further aim was to investigate how individuals participating in a multi-professional rehabilitation programme experience and understand (c) the meaning of acceptance when entering the rehabilitation programme (Study III) and (d) how this meaning change during the rehabilitation programme (Study IV). Methods and results: Three different samples were included, in total 27 women and 12 men between the ages of 24–72 years with pain duration between 2.5–35 years. In-depth interviews and a phenomenological research approach were chosen as well as a qualitative longitudinal research design. In study I, the results indicate that patients with long-term pain can be found along a spectrum from accepting to rejecting the aching body. Body awareness and a trust in ones’ body seem to be important on the path towards acceptance of the body as well as one’s life situation as whole. In study II, three constituents were identified as a gradual ‘moving forward’ process, which was characterized by a shift in attentional focus that concerns the lived body, the embodied self and the life-world beyond the experience of pain. In study III, the findings were that patients can hold different understandings of acceptance when entering a rehabilitation program expressed as; the only way forward, a possible but challenging way forward and no way forward. In study IV, four meaning structures that deepened the understanding of acceptance as well as illustrating key aspects of an embodied learning process during rehabilitation could be described; acceptance as liberation, acceptance as acknowledging the need for change, acceptance as tolerating ambivalence and acceptance as failure. Bodily-existential challenges were highlighted as well as the importance of social support. Conclusions: This thesis has shown both the importance of acceptance for rehabilitation as well as the role of embodied transformative learning. Acceptance was found to be a multifaceted phenomenon varying from person to person and over time. Although body awareness approaches are prevalent in some clinical settings, these studies show from an experiential perspective that body awareness has an important role to play in the successful rehabilitation of long-term pain. The findings in this thesis support the person-centred approach in rehabilitation, weather in group or individual treatment.
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| 8. |
- Eurenius, Eva, et al.
(författare)
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Attitudes toward physical activity among people with rheumatoid arthritis
- 2003
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Ingår i: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 9:1, s. 10-
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Tidskriftsartikel (refereegranskat)abstract
- Physical activity confers health benefits in the general population, and this also seems to apply to people with rheumatoid arthritis (RA). Less explicit barriers than pain need to be explored and overcome to initiate and successfully maintain physical activity in individuals with RA. The present aim was to describe variations in attitudes to physical activity in a group of people with RA. Sixteen people with RA were chosen to represent various ages, genders, disease duration, functioning, and health habits. Semi-structured, in-depth interviews were carried out, transcribed, qualitatively analysed, and categorised on the basis of similarities and differences. The analysis indicated that attitudes toward physical activity could not be understood without inclusion of attitudes toward the disease and sometimes to life in general. Two dimensions of attitude, motivation and satisfaction, were identified. Four categories were revealed: motivated and satisfied, unmotivated and satisfied, motivated and dissatisfied, and unmotivated and dissatisfied, each representing different attitudes to physical activity. Our findings stress the importance of developing different educational interventions that address attitudes to physical activity in order to implement a healthy life style in individuals with RA.
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| 9. |
- Karlsson, Katarina, et al.
(författare)
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Perceptions of lymphoedema treatment in patients with breast cancer - a patient perspective
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; 29:1, s. 110-117
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Tidskriftsartikel (refereegranskat)abstract
- Lymphoedema after breast cancer surgery is a chronic condition. Lymphoedema treatment consists of information/advice, compression, physical exercise, skin care, and manual lymph drainage. Little is known about how patients experience, adapt, and respond to lymphoedema treatment. Thus, the purpose of the study was to investigate and describe women's perceptions of lymphoedema treatment after breast cancer surgery. Sixteen women with breast-cancer-related lymphoedema, recruited from four hospitals and two rehabilitation clinics, participated in the study. Semi-structured interviews were conducted and analysed using a phenomenographic method. Five qualitatively different categories of description could be identified: uncertainty, disappointment, guilt and shame, safety, and autonomy. The categories could be described based on a two-dimensional structure: the patients role (internal vs. external locus of control) and an understanding of lymphoedema as a chronic disease or a burden. The study has provided a deeper understanding of different ways in which patients perceive and respond to lymphoedema treatment. The present findings enable the lymphoedema therapist to individualise treatment and counselling based on each patient's approach to the patient role, ability to take responsibility for treatment, and acceptance of lymphoedema as a chronic disease.
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| 10. |
- Kerstin, Wahman, et al.
(författare)
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What promotes physical activity after spinal cord injury? : An interview study from a patient perspective
- 2006
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 28:8, s. 481-488
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Physical activity in people with traumatic spinal cord injury (SCI) is of importance not only for maintaining health but also for increasing the possibilities of living an independent life. Physical inactivity leads to poorer muscular and cardiovascular conditioning and sub-optimal levels of functioning. To help people with SCI to achieve optimum physical activity, it is important to understand what promotes the incorporation of regular physical activity into daily life. The aim of this study was thus to identify factors that may promote participation in physical activity among people with spinal cord injuries.METHOD: Qualitative multiple case studies. Sixteen participants with SCI were interviewed.RESULT: Four main themes of promoting factors could be identified. They were: using cognitive and behavioural strategies; finding supporting environmental solutions; exploring motivation post injury; and capturing new frames of reference.CONCLUSION: By utilising the motivational power of role models, together with the other motivational factors identified in this study, such as identifying relevant individual motives post injury and capturing new frames of reference, the process towards physical active life may be facilitated.
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