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.

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. 

Aim.

This article reports a study of self-care agency and perceived health in a group

of 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, irrespective

of the specific sort of technology. A connection between self-care, perceived health

and 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. The

questionnaire addressed perceived health and daily life with medical technology.

Swedish versions of the Appraisal of Self-care Agency scale and the 13-item version

of Antonovsky’s sense of coherence scale were included.

Results.

The questionnaire was answered by 180 adults performing self-care at

home involving long-term oxygen, a ventilator, or peritoneal- or haemo-dialysis.

Health-related and technology-related variables in daily life were mostly highly

satisfactory. Perceived health was rated significantly lower among participants using

long-term oxygen. Sufficient sense of coherence, knowledge of how to use technology,

close contact with others and not feeling helpless contributed positively to

self-care agency. Positive contributing factors for perceived health were being satisfied

with life, having an active life and not feeling helpless, whereas age was a

negative factor.

Conclusion.

Daily life is manageable for people in this context. Long-term oxygen

treatment and advanced age can be regarded as risk factors for perceiving ill health.