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Experiences of health-promoting self-care in people living with rheumatic diseases
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
FoU-centrum Spenshult.
Högskolan i Halmstad.
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
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2011 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 6, 1264-1272 p.Article in journal (Refereed) Published
Abstract [en]

Aim This paper is a report of a study which explores and describes the meaning of the phenomenon health-promoting self-care as experienced by people living with rheumatic diseases.

Background People with rheumatic diseases estimate health status as low and health belief and health status influence the self-care behaviours. Several self-care behaviours are used in the efforts to mitigate the diseases.

Method The study had a descriptive phenomenological approach based on a reflective life-world perspective. Data were gathered in 2007 by unstructured open-ended interviews with 12 individuals living with rheumatic diseases.

Findings The meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care takes place against a background of continual hope and belief to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three inter-related constituents elucidated the experiences: dialogue, power struggle and choice. Self-care was experienced as dialogues within the body and with the immediate environment. In order to respond to signals from the body, power struggles were required to be entered when fighting the diseases. Choices were required to be made and things that were beneficial for the body were prioritized.

Conclusion In this study, the meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care was a way of life. This meant to be ready to understand and respond to signals from the body. Self-care required dialogues, power struggles and choices.

Place, publisher, year, edition, pages
2011. Vol. 67, no 6, 1264-1272 p.
Keyword [en]
Adults, health promoting self-care, nursing, phenomenology, rheumatic diseases, self-care
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-15006DOI: 10.1111/j.1365-2648.2010.05585.xOAI: oai:DiVA.org:hj-15006DiVA: diva2:416469
Available from: 2011-05-11 Created: 2011-05-11 Last updated: 2012-01-23Bibliographically approved
In thesis
1. Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a descriptive and interventional study
Open this publication in new window or tab >>Health promoting factors in people with chronic musculoskeletal pain or with rheumatic diseases: a descriptive and interventional study
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis with a salutogenic approach was to describe health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, and to evaluate the effects of an intervention study with a self-care promoting PBL-program for people with rheumatic diseases having chronic musculoskeletal pain, sleep disturbances and/or fatigue.

 

Methods: This thesis is comprised of four samples: a randomly selected sample from a Swedish general population (study I) and three different samples containing people with rheumatic diseases registered at a hospital for rheumatic diseases in the southwest of Sweden (studies II, III and IV). Study I had a longitudinal cohort design with an eight-year follow-up in a general population. There were 1109 participants without chronic pain and 700 participants with chronic musculoskeletal pain. Study II had a longitudinal cohort design with participants with rheumatic diseases (n=185) 12 months after rehabilitation at a hospital for rheumatic diseases. Study III had a descriptive qualitative design with a phenomenological approach based on a reflective life-world perspective. Twelve participants were interviewed about their experiences about health-promoting self-care. Study IV had a randomised controlled design with post-test six months after the one-year self-care promoting problem-based learning (PBL) program for people with rheumatic diseases. The participants were randomly assigned to the experimental group, 54 participants, or to the control group, 148 participants. Data in studies I, II and IV were analysed with statistics. In study III a Husserlian phenomenological approach based on a reflective life-world perspective was used in the data collection and analysis.

 

Results: Study I: Although participants without chronic musculoskeletal pain reported better health-related quality of life (HRQL) than participants with chronic musculoskeletal pain, similar health factors were found to promote a better HRQL in the eight-year follow-up. The most important factors were feeling rested after sleep and having good sleep structure. Study II: The most important factors promoting better outcome in HRQL 12 months after rehabilitation in participants with rheumatic diseases were having a strong sense of coherence (SOC), feeling rested after sleep, having work capacity, and having good sleep structure. Study III: The meaning of health-promoting self-care as experienced by people with rheumatic diseases was that self-care takes place against a background of continual hope and belief to be able to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three interrelated constituents elucidated the experiences: dialogue, power struggle and choice. Study IV: At the six month follow-up the participants in the experimental group had stronger empowerment after participation in the self-care promoting PBL-program compared with the control group which only got standard care for people with rheumatic diseases. There were no differences in HRQL, self-care ability, SOC, pain, quality of sleep or fatigue between the experimental group and the control group. The participants in the experimental group also stated that they had implemented lifestyle changes which they had not done without the PBL-program.

 

Conclusion: The results of this thesis provide a valuable and useful insight in health promoting factors in people with chronic musculoskeletal pain and in people with rheumatic diseases, but also in that people with rheumatic diseases have benefit from taking part in patient education with a self-care promoting PBL-program. These results contribute to evidence supporting the introduction of a more salutogenic approach in rheumatology care and research.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, Jönköping University, 2011. 164 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 17
Keyword
Adult, chronic musculoskeletal pain, empowerment, health factors, HRQL, intervention, patient education, problem-based learning, rheumatic diseases, self-care
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-15007 (URN)978-91-85835-16-4 (ISBN)
Public defence
2011-06-01, Forum Humanum, Hälsohögskolan, Jönköping, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2011-05-16 Created: 2011-05-11 Last updated: 2014-05-20Bibliographically approved

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