Living with chronic obstructive pulmonary disease and being followed uip through telemedicine - a phenomenological approach

Chronic obstructive pulmonary disease (COPD) provides substantially reduced health related quality of life (HQoL). Telemonitoring on COPD patients appears to have a positive effect on improving HQoL. This study has a phenomenological approach, and ten informants, who were followed-up between 1 and 3 months in their own homes through telemonitoring of COPD symptoms, narrated their lived experiences of HQoL. The results show that the informants experienced safety and increased knowledge through the digital dialog (telemedicine) with expertise nurses, which indirectly improved their HQoL, and in term lead to increased mastery and control in managing their disease. Several studies show an increased HQoL, but the benefits are still limited and there is a need for further research

Unlocking the limitations: living with chronic obstructive pulmonary disease and receiving care through telemedicine - a phenomenological study

Aims and objectives To describe the lived experiences of quality of life among a group of patients living with chronic obstructive pulmonary disease who were included in a telemedical intervention after hospitalisation for disease exacerbation. Background Patients with chronic obstructive pulmonary disease have high symptom burden, poor control of symptoms and a need for greater requirements in care. Telemedicine can provide benefits for patients with chronic obstructive pulmonary disease by improving self-management. Design Descriptive phenomenological approach. Methods Ten in-depth interviews were conducted with chronic obstructive pulmonary disease patients participating in a telemedical intervention. The collected data were analysed using a descriptive phenomenological research method. Results Living with chronic obstructive pulmonary disease was experienced as creating physical and mental limitations of the diseased body and an increasing identity as a patient, which led to impaired quality of life. Being included in the telemedicine intervention increased accessibility to healthcare services and support from telemedicine nurses. Self-measurement of health data increased participants’ clinical insight and created a mutual clinical language in dialogue with telemedicine nurses, which led to increased quality of life. However, receiving care through telemedicine was also experienced as a dual chore. Conclusions Telemedicine can reduce the perceived limitations imposed by chronic obstructive pulmonary disease through four key elements: (i) improving accessibility to healthcare services, (ii) increasing support from health professionals, (iii) strengthening clinical insight and (iv) developing a mutual clinical language, thus increasing quality of life. The transparency facilitated through telemedicine in this healthcare context encourages open decision-making, where the participants can increase their knowledge and improve acknowledgement of and collaboration with telemedicine nurses. Relevance to clinical practice Telemedicine can be beneficial when rethinking care for chronic obstructive pulmonary disease by providing knowledge on how living with chronic obstructive pulmonary disease can affect the experience of receiving care through telemedicine and further determine for whom telemedicine is useful.måsjekke

The meaning of actualization of self-care resources among a group of older home-dwelling people—A hermeneutic study

Self-care is an activity of mature persons who have developed their abilities to take care of themselves. Individuals can choose to actualize their self-care abilities into self-care activities to maintain, restore, or improve health and well-being. It is of importance to understand the meaning of the actualization of self-care resources among older people. The aim of this study was to investigate the meaning of the actualization of self-care resources, i.e., actions taken to improve, maintain, or restore health and well-being, among a group of older home-dwelling individuals with a high sense of coherence. The design of this study was to reanalyse narratives revealing self-care activities from 11 (five females and six males) Norwegian older home-dwelling people (65 years or older) identified as having a high sense of coherence. In order to reveal the meaning and get an understanding of why these self-care resources were realized or actualized, a Gadamerian-based research method was chosen. The analysis revealed four themes that showed the meaning of actualization of self-care resources in the study group: “Desire to carry on”, “Be of use to others”, “Self-realization”, and “Confidence to manage in the future”. The findings showed what older people found meaningful to strive for, and this information can be used as a guide for health professionals when supporting older people in their self-care. Older people with self-care resources can also be an important resource for others in need of social contact and practical help. These resources have to be asked for in voluntary work among older people in need of help and, thereby, can be a valuable supplement to the community health care system

Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative study

Objectives Patients with colorectal cancer undergoing palliative treatment receive extensive treatment-related information throughout their disease trajectory. We aimed to explore the experiences of patients with incurable colorectal cancer while in palliative care and their reflections on the information provided by physicians and nurses. Our main focus was the patients’ thoughts about how information about disease status and life expectancy was communicated, from the first time that they were informed about the incurable nature of their disease through to postsurgery palliative treatment. Settings Patients with colorectal cancer receiving palliative chemotherapy. Research design We used a qualitative approach, and the data were analysed by qualitative content analysis. Participants 20 patients (34–75 years of age) were included in the study; 12 received first-line chemotherapy and 8 received second-line chemotherapy. Eleven patients were treated by oncologists, and nine were treated by junior physicians. Results Data-driven empirical analysis identified three themes: (1) inadequate information during the initial phase of the disease trajectory; (2) hope and information further into the disease trajectory and (3) personal, professional and organisational factors that influenced information and communication throughout the disease trajectory. Conclusion The participants’ experience of being told for the first time that they had an incurable disease was perceived as inadequate, while postsurgery palliative chemotherapy, physicians and nurses offered hope. The participants preferred customised information about their treatment and likely future prospects and physicians and nurses who took a holistic and compassionate approach focusing on their lifeworld. To be a sensitive, holistic and compassionate physician or nurse requires knowledge and confidence. To achieve this requires training and guidance at universities and in hospitals

Living with chronic obstructive pulmonary disease and being followed uip through telemedicine - a phenomenological approach

Chronic obstructive pulmonary disease (COPD) provides substantially reduced health related quality of life (HQoL). Telemonitoring on COPD patients appears to have a positive effect on improving HQoL. This study has a phenomenological approach, and ten informants, who were followed-up between 1 and 3 months in their own homes through telemonitoring of COPD symptoms, narrated their lived experiences of HQoL. The results show that the informants experienced safety and increased knowledge through the digital dialog (telemedicine) with expertise nurses, which indirectly improved their HQoL, and in term lead to increased mastery and control in managing their disease. Several studies show an increased HQoL, but the benefits are still limited and there is a need for further research