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Living with an adult family member using advanced medical technology at home
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
Department of Nursing, Health and Culture, University West, Sweden/Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Norway.
2011 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 18, no 4, 336-347 p.Article in journal (Refereed) Published
Abstract [en]

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 health-care 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 were 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.

Place, publisher, year, edition, pages
Blackwell Publishing, 2011. Vol. 18, no 4, 336-347 p.
Keyword [en]
Dependent-care; Next of kin; Orem; Self-care; Transition
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-63740DOI: 10.1111/j.1440-1800.2011.00535.xISI: 000297471100007OAI: oai:DiVA.org:liu-63740DiVA: diva2:382678
Available from: 2011-01-03 Created: 2011-01-03 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: Linköping University Electronic Press, 2010. 54 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1207
Keyword
Dependent-care, health, hermeneutics, home dialysis, home ventilator, long-term oxygen, next of kin, phenomenology, transition
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-63742 (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: 2011-01-03 Created: 2011-01-03 Last updated: 2011-01-03Bibliographically approved

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Fex, AngelikaFlensner, GullviEk, Anna-Christina

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