Lisa Skär

Using information and communication technology in home care for communication between patients, family members, and healthcare professionals: a systematic review

Introduction. Information and communication technology (ICT) are becoming a natural part in healthcare both for delivering and giving accessibility to healthcare for people with chronic illness living at home. Aim. The aim was to review existing studies describing the use of ICT in home care for communication between patients, family members, and healthcare professionals. Methods. A review of studies was conducted that identified 1,276 studies. A selection process and quality appraisal were conducted, which finally resulted in 107 studies. Results. The general results offer an overview of characteristics of studies describing the use of ICT applications in home care and are summarized in areas including study approach, quality appraisal, publications data, terminology used for defining the technology, and disease diagnosis. The specific results describe how communication with ICT was performed in home care and the benefits and drawbacks with the use of ICT. Results were predominated by positive responses in the use of ICT. Conclusion. The use of ICT applications in home care is an expanding research area, with a variety of ICT tools used that could increase accessibility to home care. Using ICT can lead to people living with chronic illnesses gaining control of their illness that promotes self-care.

Embodied identity—A deeper understanding of body awareness

The aims of this study were to explore and generate an understanding of the meaning of body awareness through explanations of the experience of body awareness given by professionals and patients in psychiatric rehabilitation. A total of 20 strategically selected healthy informants were interviewed individually and in groups. Thirteen previous interviews with physiotherapists and 11 previous interviews with patients in psychiatric rehabilitation, describing their experiences of body awareness therapy and its effects were reanalyzed and included in the data for this study; in all 44 informants were included. Grounded theory methods guided the data construction and analysis. A theoretical understanding was conceptualised from which a core category of body awareness emerged: the embodied identity. This core category was related to two categories: living in the body and living in relation to others and in society. The subcategory “living in the body” was conceived as an important aspect to become more aware of the body and to experience oneself fromwithin in order to recognize ones needs. A key point was the fact that bodily experiences always exists in the present moment. The experience of the body, the balance, and stability of the physical self were basic experiences that were connected to the conception of well-being and control. To understand ones emotions and needs through the awareness of the body were understood as the base for self-confidence, trust in one-self, and the ability to take care of oneself and ones needs physically and mentally. The subcategory “living in relation to others and in society” was conceived as an important aspect for the embodied self to interact with others and for societal participation. Working with the body in physiotherapy practice should include an understanding that body awareness is inseparable from the identity and may have an impact on the health of the individual. This implies that interventions to address problems in body awareness should be integrated into physiotherapy practice.

Women's perception of changes in the social network after a spinal cord injury

Purpose. To describe how women with a spinal cord injury (SCI) perceived changes in the social network, and how these changes affected their ability to participate in occupation. Method. Thirteen women, aged 25 to 61 years, with a SCI were interviewed twice. The interviews focused on their ability to participate in occupation, their relations with individuals within the social network, and changes in the social network following the SCI. The analysis was carried out using qualitative content analysis. Results. The women described an emotional need for social support after the SCI to participate in occupation. This was a new experience that required time to adapt to. The women also described a need for practical social support from the social network members to manage meaningful occupation. After the SCI, the women had developed new habits through close cooperation with members in the social network. The women felt that they had become more responsible for the development of their relations. Many relations had improved after the SCI, while some had decreased. The women had also developed new relations with other persons with disabilities. Conclusions. The women perceived substantial changes in the social network following the SCI, which in several ways affected their ability to participate in occupation. To adapt to their new life situation, the women gradually developed different strategies. The results point out the need to identify persons in the social network that women with SCI develop relations with, and integrate them in the rehabilitation process.

How I Play: Roles and Relations in the Play Situations of Children with Restricted Mobility

The purpose of this grounded theory study was to gain knowledge and understanding of how children with restricted mobility play in different play situations. The group investigated consisted of 10 children with restricted mobility, aged from 6 to 12 years, living in northern Sweden. In this study, the child with restricted mobility is defined as a child unable to move around without the aid of a wheelchair, walking trolley, crutches or other walking device. The children were interviewed about play and were observed in different play situations. The transcribed interviews and observations were analysed according to the constant comparative method of grounded theory described by Glaser and Strauss (1967). The analysis resulted in a model (How I play, core category) describing the childs relations in different play situations, the factors that gave rise to different types of play and the consequences of the play. The different types of play were: (A) play with friends - (a) interactive play and (b) onlooker play; (B) play alone; and (C) play with adults. Most play came to be placed in categories B and C, that is the children played mostly alone or with adults. The results were discussed on the basis of Meads theory of identity development and Bronfenbrenners theory of developmental ecology, that is how childrens play influences their development when adults are so often present.

Meanings of Feeling Well for Women With Multiple Sclerosis

In research concerning multiple sclerosis (MS), the factors that impact on people’s well-being and quality of life have been studied, but little has been written about what it means to feel well for women with MS. Therefore, in this study our aim was to describe meanings of feeling well for women with MS. We interviewed 15 women with MS, and a phenomenological hermeneutic interpretation was utilized to analyze the interviews. Through this study it can be understood that finding a pace where daily life goes on means that women with MS feel well when the illness is kept in check and is not the dominant experience. The findings of this study can be used to confirm women’s experiences of feeling well, despite living with the consequences of MS. Health care professionals will find the results of this study useful when they reflect on and formulate the care of women with MS when attempting to support the latter’s desire to feel well in their daily lives.

To regain participation in occupations through human encounters - narratives from women with spinal cord injury

Purpose. To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. Method. The data were collected through two or three in-depth interviews with 13 women (age 25 – 61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. Results. The results showed a complexity where the womens experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. Conclusions. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability.

Fatigue in chronic obstructive pulmonary disease: a qualitative study of people's experiences

BACKGROUND Fatigue is reported to be one of the most common symptoms among people with chronic obstructive pulmonary disease COPD. However, there is hardly any qualitative research describing how fatigue affects people living with this illness. AIM To describe peoples experience of fatigue in daily life when living with moderate to very severe COPD. METHODS A purposive sample of 20 people with COPD stages II-IV was recruited from the Obstructive Lung Disease in Northern Sweden COPD study. Data were collected through semi-structured interviews with participants regarding their experience of fatigue. The interviews were subjected to qualitative content analysis. RESULTS One theme was identified: Reconcile with the dimensions of fatigue, and four categories were identified: To understand the reasons of fatigue, To preserve fatigue unexpressed, When fatigue takes control and How to manage fatigue. Fatigue seems to be an always-present feeling, involving the whole body, raising feelings of hopelessness and controlling ones life. It seems to be accepted as a natural consequence of COPD and may therefore remain unexpressed. Further, when experienced with dyspnoea, fatigue becomes even heavier and more difficult to manage. To gain control of fatigue, people plan daily life and continue with physical activities. CONCLUSION Fatigue affects the daily lives of people with COPD. Perceived with dyspnoea, fatigue was described as overwhelming. Most importantly, fatigue seems to be unexpressed to healthcare professionals and relatives.

Social support provides motivation and ability to participate in occupation

In this study, a qualitative perspective of how 13 women (aged 25 to 61 years) with spinal cord injury perceive the importance of social support for their participation in occupation is presented. The data were collected through repeated in-depth interviews and field notes, and the analysis used a grounded theory approach. The women needed both emotional and practical support, which was important in a time perspective and motivated them to participate in occupation. The women needed to receive support soon after the injury, but after a period of time they needed to give and receive support in a reciprocal fashion. Social support is therefore an effective rehabilitation strategy that can motivate people with disabilities to participate in meaningful occupation. The importance of social support for a persons motivation and ability to participate in occupation expands our knowledge of the relationship between individuals, their social environment, and occupation.

Living with a double burden: Meanings of pain for women with fibromyalgia

Living with fibromyalgia (FM) means living with a chronic pain condition that greatly influences daily life. The majority of people with FM are middle-aged women. The aim of this study was to elucidate meanings of pain for women with FM. Fifteen women with FM were interviewed about their pain experiences and a phenomenological hermeneutic interpretation was used to analyse the interview texts. The findings show that meanings of pain for women with FM can be understood as living with a double burden; living with an aggressive, unpredictable pain and being doubted by others in relation to the invisible pain. The ever-present pain was described as unbearable, overwhelming, and dominated the womens whole existence. Nevertheless, all the women tried to normalize life by doing daily chores in an attempt to alleviate the pain. In order to support the womens needs and help them to feel well despite their pain, it is important that nurses and health care personnel acknowledge and understand women with FM and their pain experiences.

Swedish District Nurses’ Attitudes to Implement Information and Communication Technology in Home Nursing

The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses’ attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses’ from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the current and future use of information and communication technology in home nursing; expectations, advantages, disadvantages and hindrances in the use of information and communication technology in home nursing; and the use of information and communication technology from an ethical perspective. The transcribed focus group discussions were analysed using qualitative content analysis. The results showed that district nurses’ attitudes were positive regarding the use of information and communication technology in their work. They also asked for possibilities to influence the design and its introduction. However, the use of information and communication technology in home nursing can be described as a complement to communication that could not replace human physical encounters. Improvements and risks, as well as the importance of physical presence in home nursing were considered vital. The results revealed that the use of information and communication technology requires changes in the district nurses’ work situation.