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Tase A, Vadhwana B, Buckle P, Hanna GB. Usability challenges in the use of medical devices in the home environment: A systematic review of literature. APPLIED ERGONOMICS 2022; 103:103769. [PMID: 35430424 DOI: 10.1016/j.apergo.2022.103769] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Home care medical devices are the fastest-growing segment of the medical device industry with associated safety and usability challenges. Human factor studies in the home environment present many difficulties resulting in limited knowledge of device use in this setting. This systematic review aims to identify usability challenges reported directly by end-users in the home environment. METHODS A systematic review of the literature was conducted concentrating on studies involving end user reporting. Reported challenges were grouped into a) device-user, b) device use environment and c) device-user interface challenges. RESULTS 3471 studies were screened and 202 underwent full-text review. Only twelve studies had direct involvement of end users. Multiple challenges were identified, with device-user interface problems being the most common. No effective, standardised method was found to collect patient/user feedback on usability challenges in the post-market stage, leading to a knowledge gap. CONCLUSIONS This study brought together multiple usability challenges reported by individual studies. Involvement of medical device end-users in usability studies is essential and their experiences must be effectively utilised in device design.
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Lolich L, Pirhonen J, Turja T, Timonen V. Technology in the Home Care of Older People: Views from Finland and Ireland. J Cross Cult Gerontol 2022; 37:181-200. [DOI: 10.1007/s10823-022-09449-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 10/18/2022]
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Nourse R, Lobo E, McVicar J, Kensing F, Islam SMS, Kayser L, Maddison R. Characteristics of smart health ecosystems that support self-care among people with heart failure: A scoping review (Preprint). JMIR Cardio 2022; 6:e36773. [DOI: 10.2196/36773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/22/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
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Technology use expression of Maslow's hierarchy need. Asian J Psychiatr 2020; 48:101895. [PMID: 31901585 DOI: 10.1016/j.ajp.2019.101895] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 12/05/2019] [Indexed: 11/23/2022]
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Schaepe C, Ewers M. "I see myself as part of the team" - family caregivers' contribution to safety in advanced home care. BMC Nurs 2018; 17:40. [PMID: 30220881 PMCID: PMC6137892 DOI: 10.1186/s12912-018-0308-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The use of medical technology and the various contributing and interdepending human factors in home care have implications for patient safety. Although family caregivers are often involved in the provision of advanced home care, there is little research on their contribution to safety. The study aims to explore family caregivers in Home Mechanical Ventilation (HMV) safety experiences and how safety is perceived by them in this context. Furthermore, it seeks to understand how family caregivers contribute to the patients' and their own safety in HMV and what kind of support they expect from their health care team. METHODS An explorative, qualitative study was applied using elements from grounded theory methodology. Data were collected through individual interviews with 15 family caregivers to patients receiving HMV in two regions in Germany. The audiotaped interviews were then subject to thematic analysis. RESULTS The findings shows that family caregivers contribute to safety in HMV by trying to foster mutual information sharing about the patient and his/her situation, coordinating informally health care services and undertaking compensation of shortcomings in HMV. CONCLUSION Consequently, family caregivers take on considerable responsibility for patient safety in advanced home care by being actively and constantly committed to safety work.Nurses working in this setting should be clinically and technically skilled and focus on building partnership relations with family caregivers. This especially encompasses negotiation about their role in care and patient safety. Support and education should be offered if needed. Only skilled nurses, who can provide safe care and who can handle critical situations should be appointed to HMV. They should also serve as professional care coordinators and provide educational interventions to strengthen family caregivers' competence.
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Affiliation(s)
- Christiane Schaepe
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Health and Nursing Science, Berlin, Germany
| | - Michael Ewers
- Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Health and Nursing Science, Berlin, Germany
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Ten Haken I, Ben Allouch S, van Harten WH. The use of advanced medical technologies at home: a systematic review of the literature. BMC Public Health 2018; 18:284. [PMID: 29482550 PMCID: PMC6389044 DOI: 10.1186/s12889-018-5123-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 01/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background The number of medical technologies used in home settings has increased substantially over the last 10–15 years. In order to manage their use and to guarantee quality and safety, data on usage trends and practical experiences are important. This paper presents a literature review on types, trends and experiences with the use of advanced medical technologies at home. Methods The study focused on advanced medical technologies that are part of the technical nursing process and ‘hands on’ processes by nurses, excluding information technology such as domotica. The systematic review of literature was performed by searching the databases MEDLINE, Scopus and Cinahl. We included papers from 2000 to 2015 and selected articles containing empirical material. Results The review identified 87 relevant articles, 62% was published in the period 2011–2015. Of the included studies, 45% considered devices for respiratory support, 39% devices for dialysis and 29% devices for oxygen therapy. Most research has been conducted on the topic ‘user experiences’ (36%), mainly regarding patients or informal caregivers. Results show that nurses have a key role in supporting patients and family caregivers in the process of homecare with advanced medical technologies and in providing information for, and as a member of multi-disciplinary teams. However, relatively low numbers of articles were found studying nurses perspective. Conclusions Research on medical technologies used at home has increased considerably until 2015. Much is already known on topics, such as user experiences; safety, risks, incidents and complications; and design and technological development. We also identified a lack of research exploring the views of nurses with regard to medical technologies for homecare, such as user experiences of nurses with different technologies, training, instruction and education of nurses and human factors by nurses in risk management and patient safety.
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Affiliation(s)
- Ingrid Ten Haken
- Saxion University of Applied Sciences, Research Group Technology, Health & Care (TH&C), P.O. Box 70.000, 7500, KB, Enschede, The Netherlands.
| | - Somaya Ben Allouch
- Saxion University of Applied Sciences, Research Group Technology, Health & Care (TH&C), P.O. Box 70.000, 7500, KB, Enschede, The Netherlands
| | - Wim H van Harten
- Department Health Technology & Services Research (HTSR), University of Twente, Faculty Behavioural, Management and Social Sciences (BMS), Ravelijn 5246, P.O. Box 217, 7500, AE, Enschede, The Netherlands.,Rijnstate General Hospital, Arnhem, The Netherlands
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Lindberg C, Fagerström C, Willman A, Sivberg B. Befriending Everyday Life When Bringing Technology Into the Private Sphere. QUALITATIVE HEALTH RESEARCH 2017; 27:843-854. [PMID: 26848081 DOI: 10.1177/1049732315627428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We present the findings of our phenomenological interview study concerning the meaning of being an autonomous person while dependent on advanced medical technology at home. This was elucidated in the participants' narratives as befriending everyday life when bringing technology into the private sphere. We discovered four constituents of the phenomenon: befriending the lived body, depending on good relationships, keeping the home as a private sphere, and managing time. The most important finding was the overall position of the lived body by means of the illness limiting the control over one's life. We found that the participants wanted to be involved in and have influence over their care to be able to enjoy autonomy. We therefore stress the importance of bringing the patients into the care process as chronic illness will be a part of their everyday life for a long time to come, hence challenging patient autonomy.
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Munck B, Sandgren A. The impact of medical technology on sense of security in the palliative home care setting. Br J Community Nurs 2017; 22:130-135. [PMID: 28252328 DOI: 10.12968/bjcn.2017.22.3.130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The increase in the use of medical devices in palliative home care requires that patients and next-of-kin feel secure. Therefore, the aim was to describe medical technology's impact on the sense of security for patients, next-of-kin and district nurses. Deductive content analysis was conducted on data from three previous studies, using the theoretical framework 'palliative home care as a secure base'. The use of medical technology was shown to have an impact on the sense of security for all involved. A sense of control was promoted by trust in staff and their competence in managing the technology, which was linked to continuity. Inner peace and being in comfort implied effective symptom relief facilitated by pain pumps and being relieved of responsibility. Health care professionals need to have practical knowledge about medical technology, but at the same time have an awareness of how to create and maintain a sense of security.
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Affiliation(s)
- Berit Munck
- District Nurse, Senior Lecturer, Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden
| | - Anna Sandgren
- Senior Lecturer, Co-director, Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Sweden
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The Impact of Long-Term Home Parenteral Nutrition on the Patient and the Family. JOURNAL OF INFUSION NURSING 2015; 38:290-300. [DOI: 10.1097/nan.0000000000000112] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Palmer SC, Hanson CS, Craig JC, Strippoli GF, Ruospo M, Campbell K, Johnson DW, Tong A. Dietary and Fluid Restrictions in CKD: A Thematic Synthesis of Patient Views From Qualitative Studies. Am J Kidney Dis 2015; 65:559-73. [DOI: 10.1053/j.ajkd.2014.09.012] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 09/07/2014] [Indexed: 11/11/2022]
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Baillie J, Lankshear A. PATIENTS’ AND RELATIVES’ EXPERIENCES OF PERITONITIS WHEN USING PERITONEAL DIALYSIS. J Ren Care 2015; 41:177-86. [DOI: 10.1111/jorc.12118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jessica Baillie
- School of Healthcare Sciences; Cardiff University; Cardiff UK
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12
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Bjuresäter K, Larsson M, Athlin E. Patients’ experiences of home enteral tube feeding (HETF) – a qualitative study. J Res Nurs 2015. [DOI: 10.1177/1744987114568655] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Use of home enteral tube feeding (HETF) has increased in Western countries but research is scarce, especially about patients’ experiences of daily life when being treated with HETF. This study aimed to explore what it means to live with HETF and how the situation can be managed. A qualitative method was carried out according to Grounded Theory. In total, 22 interviews were performed with 11 patients treated with HETF for between 8 weeks and 2 years, using open-ended questions. Sampling, data collection and data analysis were carried out simultaneously. To be treated with HETF was experienced as positive as it meant survival, but the most prominent finding told about experiences of restrictions, practical problems and distress in the patients’ daily lives. How daily life turned out seemed to depend on the patient’s ability to manage problems, but was also strongly related to the amount and quality of information and support they received from health professionals. Lacking preparation before discharge as well as lacking support at home meant insecurity and uncertainty. The findings stress the need for comprehensive preparation and support from health professionals, and improvements are needed to facilitate HETF patients’ daily life.
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Affiliation(s)
- Kaisa Bjuresäter
- Senior Lecturer, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Maria Larsson
- Associate Professor, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
| | - Elsy Athlin
- Professor, Institution of Health Sciences, Karlstad University, Karlstad, Sweden
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Baillie J, Lankshear A. Patient and family perspectives on peritoneal dialysis at home: findings from an ethnographic study. J Clin Nurs 2014; 24:222-34. [DOI: 10.1111/jocn.12663] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica Baillie
- School of Healthcare Sciences; Cardiff University; Cardiff UK
| | - Annette Lankshear
- Cardiff School of Healthcare Sciences; Cardiff University; Cardiff UK
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Chopy K, Winkler M, Schwartz‐Barcott D, Melanson K, Greene G. A Qualitative Study of the Perceived Value of Membership in The Oley Foundation by Home Parenteral and Enteral Nutrition Consumers. JPEN J Parenter Enteral Nutr 2014; 39:426-33. [DOI: 10.1177/0148607114527134] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 02/13/2014] [Indexed: 11/15/2022]
Affiliation(s)
- Katelyn Chopy
- Department of Nutrition & Food Sciences, University of Rhode Island, Kingston, Rhode Island
| | - Marion Winkler
- Rhode Island Hospital and Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Kathleen Melanson
- Department of Nutrition & Food Sciences, University of Rhode Island, Kingston, Rhode Island
| | - Geoffrey Greene
- Department of Nutrition & Food Sciences, University of Rhode Island, Kingston, Rhode Island
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Thomson R, Martin JL, Sharples S. The psychosocial impact of home use medical devices on the lives of older people: a qualitative study. BMC Health Serv Res 2013; 13:467. [PMID: 24195757 PMCID: PMC4226280 DOI: 10.1186/1472-6963-13-467] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 11/04/2013] [Indexed: 11/17/2022] Open
Abstract
Background Increased life expectancy and the accompanying prevalence of chronic conditions have led to the focus and delivery of health care migrating from the hospital and into people’s homes. While previous studies have investigated the integration of particular types of medical devices into the home, it was our intention to describe how medical devices are integrated into the lives of older people. Methods Adopting a qualitative study design, 12 older people, who used medical devices in the home, took part in in-depth, semi structured interviews. In 7 of the interviews participants and their partners were interviewed together. These interviews were recorded, transcribed and analysed thematically. Results Two themes were constructed that describe how medical devices that are used in the home present certain challenges to older people and their partners in how the device is adopted and the personal adaptations that they are required to make. The first theme of 'self-esteem’ highlighted the psychological impact on users. The second theme of 'the social device' illustrated the social impact of these devices on the user and the people around them. Conclusions We found that these devices had both a positive and negative psychosocial impact on users’ lives. An improved understanding of these psychological and social issues may assist both designers of medical devices and the professionals who issue them to better facilitate the integration of medical devices into the homes and lives of older people.
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Affiliation(s)
- Ross Thomson
- Faculty of Engineering, University of Nottingham, Tower Building, University Park Nottingham, Nottingham NG7 2RD, UK.
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Correa G, Domènech M. Care networking: a study of technical mediations in a home telecare service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3072-88. [PMID: 23880730 PMCID: PMC3734477 DOI: 10.3390/ijerph10073072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/05/2013] [Accepted: 07/09/2013] [Indexed: 11/16/2022]
Abstract
This article examines the processes of technical mediation within familial care networks based on a study of home telecare targeted at older people. Supported by contributions from the actor-network theory as part of the social psychology of science and technology, these processes of technical mediation are analyzed using a qualitative approach. The data were gathered through six focus groups and four in-depth interviews; the participants in the study included users, relatives and formal carers. Thematic analysis techniques encompassing the information were used, revealing the effects on the patterns of caring relationships. The results show the interplay between presence-absence made possible by the devices; the two-way direction of care between the older people and the artifacts; and the process of sustaining care using the technology. We conclude that care should be seen as a socio-technical network where technology plays an active role in sustaining family relationships.
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Affiliation(s)
- Gonzalo Correa
- Departament de Psicologia Social, Universitat Autònoma de Barcelona, Barcelona 8014, Spain.
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Tong A, Lesmana B, Johnson DW, Wong G, Campbell D, Craig JC. The perspectives of adults living with peritoneal dialysis: thematic synthesis of qualitative studies. Am J Kidney Dis 2012. [PMID: 23177729 DOI: 10.1053/j.ajkd.2012.08.045] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Most patients with end-stage renal disease require dialysis to survive because they are unable to access kidney transplantation. Peritoneal dialysis (PD) is recommended by some clinical practice guidelines as the dialysis treatment of choice for adults without significant comorbid conditions or those with residual kidney function. This study aims to synthesize published qualitative studies of patients' experiences, beliefs, and attitudes about PD. METHODS We conducted a systematic review and thematic synthesis of qualitative studies of adult perspectives of living with PD. Databases (MEDLINE, Embase, PsycINFO, and CINAHL), theses, and reference lists were searched to November 2011. RESULTS 39 studies involving 387 participants were included. We identified 7 themes: resilience and confidence (determination and overcoming vicissitudes), support structures (strong family relationship, peer support, professional dedication, social abandonment, and desire for holistic care), overwhelming responsibility (disruptive intrusion, family burden, and onerous treatment regimen), control (gaining bodily awareness, achieving independence and self-efficacy, and information seeking), freedom (flexibility and autonomy, retaining social functioning, and ability to travel), sick identity (damage to self-esteem and invisible suffering), and disablement (physical incapacitation and social loss and devaluation). CONCLUSIONS PD can offer patients a sense of control, independence, self-efficacy, and freedom. However, holistic and multidisciplinary care is needed to mitigate the risks of impaired self-esteem, physical incapacitation, reduced social functioning, and poor sense of self-worth. Strategies that aim to strengthen social support and promote resilience and confidence in patients are integral to achieving positive adjustment, improved psychosocial outcomes, and treatment satisfaction.
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Affiliation(s)
- Allison Tong
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia.
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Swedberg L, Chiriac EH, Törnkvist L, Hylander I. Patients in 24-hour home care striving for control and safety. BMC Nurs 2012; 11:9. [PMID: 22697419 PMCID: PMC3482607 DOI: 10.1186/1472-6955-11-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 06/14/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This article concerns Swedish patients receiving 24-hour home care from health care assistants (HC assistants) employed by the municipality. Home care is a complex interactive process involving the patient, family, HC assistants as well as professional care providers. Previous studies exploring patient perspectives on home care have been based mainly on patient interviews. In contrast, the present study took a broad perspective on patients' experiences and thoughts by combining field observations on care situations with patient and HC assistant interviews. The aim of the study presented in this article was to promote a new and broadened understanding of patients receiving 24-hour home care by constructing a theoretical model to illuminate their main concern. METHODS Field observations and semi-structured interviews were conducted with four patients receiving 24-hour home care and their HC assistants. Grounded theory methodology was used. RESULTS The core process identified was Grasping the lifeline, which describes compensatory processes through which patients strived for control and safe care when experiencing a number of exposed states due to inadequate home care. Patients tried to take control by selecting their own HC assistants and sought safe hands by instructing untrained HC assistants in care procedures. When navigating the care system, the patients maintained contacts with professional care providers and coordinated their own care. When necessary, a devoted HC assistant could take over the navigating role. The results are illuminated in a theoretical model. CONCLUSIONS The results accentuate the importance to patients of participating in their own care, especially in the selection of HC assistants. The model illustrates some challenging areas for improvement within the organisation of 24-hour home care, such as personnel continuity and competence, collaboration, and routines for acute care. Furthermore, it may be used as a basis for reflection during the planning of care for individual patients within home care.
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Affiliation(s)
- Lena Swedberg
- Department of Neurobiology, Care Science and Society, Centre for Family Medicine (CeFAM), Karolinska Institutet, Alfred Nobels alle´12, S-14284, Huddinge, Sweden
| | - Eva Hammar Chiriac
- Department of Behavioural Sciences and Learning, Linköping University, S-581 83, Linköping, Sweden
| | - Lena Törnkvist
- Department of Neurobiology, Care Science and Society, Centre for Family Medicine (CeFAM), Karolinska Institutet, Alfred Nobels alle´12, S-14284, Huddinge, Sweden
| | - Ingrid Hylander
- Department of Neurobiology, Care Science and Society, Centre for Family Medicine (CeFAM), Karolinska Institutet, Alfred Nobels alle´12, S-14284, Huddinge, Sweden
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Munck B, Sandgren A, Fridlund B, Mårtensson J. Next-of-kin’s conceptions of medical technology in palliative homecare. J Clin Nurs 2012; 21:1868-77. [DOI: 10.1111/j.1365-2702.2012.04123.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fex A, Flensner G, Ek AC, Söderhamn O. Self-care agency and perceived health among people using advanced medical technology at home. J Adv Nurs 2011; 68:806-15. [DOI: 10.1111/j.1365-2648.2011.05781.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Gruman JC. Making health information technology sing for people with chronic conditions. Am J Prev Med 2011; 40:S238-40. [PMID: 21521600 DOI: 10.1016/j.amepre.2011.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 01/14/2011] [Accepted: 02/01/2011] [Indexed: 12/21/2022]
Affiliation(s)
- Jessie C Gruman
- Center for Advancing Health, 2000 Florida Avenue NW, Washington, DC 20009, USA.
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Bjuresäter K, Larsson M, Athlin E. Struggling in an inescapable life situation: being a close relative of a person dependent on home enteral tube feeding. J Clin Nurs 2011; 21:1051-9. [PMID: 21418362 DOI: 10.1111/j.1365-2702.2010.03596.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To explore what it means to be a close relative of a person dependent on home enteral tube feeding (HETF) and how they can manage this situation. BACKGROUND Previous studies have shown that the situation of close relatives in home care in general can be burdensome and difficult. Research is scarce about experiences of close relatives when patients are treated with HETF. DESIGN A qualitative design was used, in accordance with grounded theory (GT). METHODS Twelve close relatives were interviewed twice, using open-ended questions. Five were relatives of patients supported by home care services or advanced home care teams. Using the GT method, sampling, data collection and data analysis were carried out simultaneously. RESULTS One core category, 'Struggling in an inescapable life situation' and eight categories were found. The situation led to involuntary changes in the lives of the close relatives, something they could do little about. Their lives had become completely upturned and restricted by the HETF. Togetherness and pleasure was lost and they felt lonely. The relatives faced a new role of being informal caregivers and they had to adjust their daily life accordingly. They felt forced to take on a heavy responsibility for which they lacked support. The close relatives struggled to manage and to make the best of their new situation. CONCLUSIONS This study highlighted the demands and vulnerability which is embedded in the role of being a close relative of a patient with HETF. It also pointed out their need for comprehensive support from the health care system. RELEVANCE TO CLINICAL PRACTICE Support to facilitate the situation of close relatives should be given from the health care. One way to organise the care could be through a nurse-led clinic, which provides continuous support, information and counseling.
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Hemodialysis arteriovenous fistula self-cannulation: moving theory to practice in developing patient-teaching resources. CLIN NURSE SPEC 2010; 24:304-12. [PMID: 20940568 DOI: 10.1097/nur.0b013e3181f903b8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE/OBJECTIVES This article discusses how Orem's theory was applied to the revision of supporting documents in the patient-teaching process and subsequently the nurse's role in the patient's learning experience. BACKGROUND/RATIONALE Teaching based on didactic, provider-focused objectives is ineffective in meeting patient's learning needs. There is a lack of conclusive research on the development of appropriate patient-teaching endeavors for the acquisition of knowledge and skills related to the performance of hemodialysis arteriovenous fistula self-cannulation. DESCRIPTION OF THE PROJECT/INNOVATION To prepare patients for home hemodialysis, Orem's self-care-deficit nursing theory was used to guide the revisions of a patient assessment and learning documentation template, the development of a self-cannulation teaching resource and to foster a renewed sense of the nurse's role in the teaching process. INTERPRETATION/CONCLUSION The application of self-care-deficit nursing theory to the update and development of patient-teaching documentation and resources for self-cannulation provides the nurse with a theoretical approach to assess, plan, evaluate, and document teaching from a patient-focused perspective. Theory in practice provides a means to support and highlight the role of nurses in the patient-learning process. The utilization of practical activities to introduce theory into teaching provides a means to structure care processes and to enhance nurse's adoption of theory in practice. IMPLICATIONS Orem's theory provides a relevant, useful framework to guide nurses in teaching patients self-care. Research on the exploration of nurse's attitudes related to the benefit of adopting theory when teaching patients to perform hemodialysis self-care is needed.
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Gruman J, Rovner MH, French ME, Jeffress D, Sofaer S, Shaller D, Prager DJ. From patient education to patient engagement: implications for the field of patient education. PATIENT EDUCATION AND COUNSELING 2010; 78:350-6. [PMID: 20202780 DOI: 10.1016/j.pec.2010.02.002] [Citation(s) in RCA: 194] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 02/02/2010] [Accepted: 02/03/2010] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Advances in health care require that individuals participate knowledgeably and actively in their health care to realize its full benefit. Implications of these changes for the behavior of individuals and for the practice of patient education are described. METHODS An "engagement behavior framework" (EBF) was compiled from literature reviews and key informant interviews. To assess the focus of research and interventions on the identified engagement behaviors, the EBF was used to code scientific sessions in professional conferences relevant to patient education in the US in 2006-2007. RESULTS Many specific behaviors constitute engagement. Professional conferences on patient education show only modest attention to the full range of relevant behaviors. CONCLUSION People must make informed choices about insurance and clinicians, coordinate communications among providers and manage complex treatments on their own. Not doing so risks preventable illness, suboptimal outcomes and wasted resources. PRACTICE IMPLICATIONS Increased responsibilities of individuals, sick and well, to find and actively participate in high quality health care provides an opportunity for patient education researchers and clinicians to improve health outcomes by developing innovative strategies to support all individuals to effectively participate in their care to the extent possible.
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Affiliation(s)
- Jessie Gruman
- Center for Advancing Health, Washington, DC 20009-1231, USA.
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