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Health–illness transition among persons using advanced medical technology at home
University West, Department of Nursing, Health and Culture, Division of Nursing.
University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.ORCID iD: 0000-0001-8017-0998
Linköpings universitet, Institutionen för medicin och hälsa.
University West, Department of Nursing, Health and Culture, Division of Advanced Nursing.ORCID iD: 0000-0003-3158-9981
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 253-261Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Blackwell , 2011. Vol. 25, no 2, p. 253-261
Keywords [en]
acceptance, high-tech care, lived experience, phenomenological hermeneutics, self-care
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-2959DOI: 10.1111/j.1471-6712.2010.00820.xOAI: oai:DiVA.org:hv-2959DiVA, id: diva2:381720
Available from: 2010-12-28 Created: 2010-12-28 Last updated: 2017-12-11Bibliographically approved
In thesis
1. From novice towards self-care expert : studies of self-care among persons using advanced medical technology at home 
Open this publication in new window or tab >>From novice towards self-care expert : studies of self-care among persons using advanced medical technology at home 
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

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.  

Place, publisher, year, edition, pages
Linköping: Department of Medical and Health Sciences, Linköping University, 2010. p. 54
Series
Linköping University medical dissertations, ISSN 0345-0082 ; 1207
Keywords
Home care services, Self care, Technology, medical, Dependent-care, Health, Hermeneutics, Home dialysis, Home ventilator, Long-term oxygen, Next of kin, Phenomenology, Transition, Egenvård, Medicinsk teknik
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-3174 (URN)978-91-7393-313-1 (ISBN)
Public defence
2010-12-15, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2011-02-24 Created: 2011-02-02 Last updated: 2011-02-24Bibliographically approved

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Flensner, GullviSöderhamn, Olle

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