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Damsgaard S, Allergodt K, Handberg C. Women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process. J Clin Nurs 2024. [PMID: 38326939 DOI: 10.1111/jocn.17067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/28/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
AIM To explore Danish women's experiences with opting out of cervical cancer screening and the role of the nurse in the women's decision-making process. DESIGN A qualitative study using semi-structured, individual interviews with a phenomenological-hermeneutic approach. METHODS Interviews were conducted with 13 women with experience in opting out of cervical cancer screening. Women were recruited through a public flyer and interviewed virtually or by phone. The interviews were analysed using the theory of interpretation from Paul Ricoeur and consisted of three levels: naïve reading, structural analysis, and critical discussion and analysis. The present study adheres to the COREQ guidelines. RESULTS The women experience various personal causes for opting out of cervical cancer screening, such as low accessibility of screening appointments, discomfort during the smear test, fear of being sick, and insufficient information about the relevance of screening to the individual woman. The perceived disadvantages of screening outweighed their perceived advantages. The women's experiences did not include the role of the nurse in the procedures and knowledge sharing related to cervical cancer screening. However, nurses were described as having good communicative and relational qualifications relevant to being involved in cervical cancer screening. CONCLUSION It was challenging for the women to weigh the advantages and disadvantages of cervical cancer screening and thus to make an informed decision about participation. They expressed a need for more information on which to base their decision. This places nurses in a much needed, yet unexplored, role of identifying and lowering potential personal barriers that may outweigh the women's perceived benefits of participating in screening. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE Nurses should play a more active role in cervical cancer screening such as improving general knowledge and facilitating two-way communication about its relevance. REPORTING METHOD The present study adheres to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Signe Damsgaard
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Kristin Allergodt
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Research and Development, National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- Research and Development, National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Vrist LTH, Knudsen LF, Handberg C. 'It becomes the new everyday life' - experiences of chronic pain in everyday life of people with limb-girdle muscular dystrophy. Disabil Rehabil 2023; 45:3875-3882. [PMID: 36343207 DOI: 10.1080/09638288.2022.2142679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 10/03/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To investigate experiences and reflections on challenges in everyday life of people living with limb-girdle muscular dystrophy (LGMD) and chronic pain in order to improve rehabilitation services. MATERIALS AND METHODS The design for this study was qualitative using the Interpretive Description methodology and the salutogenic theory of Sense of Coherence as the theoretical framework. Four semi-structured focus group interviews were conducted with 19 adults with LGMD from April to May 2021. The interviews were conducted online due to COVID-19. RESULTS Living with chronic pain and LGMD affected everyday life in terms of the participants' overall Sense of Coherence. Beneficial or unfavorable coping strategies were identified within four interrelated categorical themes: pain management, normality comprehension, affected emotional sentiment and altered identity. CONCLUSION Healthcare professionals should acknowledge possible chronic pain secondary to LGMD. Chronic pain appears to be a prevalent problem in people with LGMD with negative impact on everyday life, yet patients with LGMD did not receive sufficient information and necessary tools from health professionals to cope with chronic pain. Thus, adequate pain management appeared to be a difficult and self-taught process. Educating health professionals on how to support patients with LGMD and chronic pain is needed.IMPLICATIONS FOR REHABILITATIONHealth professionals should acknowledge and address the possibility of chronic pain secondary to limb-girdle muscular dystrophy (LGMD) and educate patients in pain management.Physiotherapy, energy management and engagement in meaningful activities may help patients gain some control of pain and limit the consequences of pain on everyday life.Supporting patients to accept pain and to shift focus towards their current capabilities may potentially improve pain management.Educating health professionals on how to support patients with LGMD and chronic pain is needed.
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Affiliation(s)
- Louise T H Vrist
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Lone F Knudsen
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Ørtenblad L, Maribo T, Quistgaard B, Madsen E, Handberg C. The ambiguity of goal-setting: a study of patients' perspectives on goal-setting in outpatient multidisciplinary rehabilitation of patients with spinal cord injury. Disabil Rehabil 2023; 45:3342-3351. [PMID: 36131619 DOI: 10.1080/09638288.2022.2125087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Spinal cord injury (SCI) is a complex health condition requiring long-term rehabilitation. Person-centred goal-setting is a central component of rehabilitation. However, knowledge of patients' perspectives on the goal-setting in SCI rehabilitation is scarce. The purpose was therefore to explore patients' perspectives on goal-setting in multidisciplinary SCI rehabilitation. MATERIALS AND METHODS An anthropological study combining participant-observation and individual interviews. Data were analysed using reflexive thematic analysis. The COREQ checklist was used to report study quality. RESULTS Patients with SCI perceived goal-setting as ambiguous. On the one hand, they considered it insignificant, because it was complicated to transform complex needs of everyday life to recommended criteria of goals being measurable, specific, and realistic. On the other hand, they considered it a potentially useful guiding tool. Patients were uncertain of impact of goals and perceived goal-setting as vague during rehabilitation. Patient involvement was challenged by insufficient integration of patients' experience-based knowledge of everyday life and clinicians' profession-based knowledge. CONCLUSIONS Goal-setting in rehabilitation is not the patients' need but they accept it as the clinicians' framework for rehabilitation. For goal-setting to become meaningful to patients with SCI, patient involvement should be strengthened by equally integrating the patients' perspectives in the goal-setting process.Implications for rehabilitationHealth-care professionals have to strengthen patient involvement in SCI rehabilitation by to a greater extent integrating the patients' knowledge of their everyday life and preferences rather than primarily focusing on profession-based knowledge.Health-care professionals must support patients in setting goals which are practically meaningful and relevant to the patients' everyday life and achievably and if needed go beyond the structured measurement of SMART goals.In an acknowledgement of the dynamic nature of goal-setting, clinicians should emphasise formulating goals in a flexible and non-directive manner, thereby providing room for patients' changing needs and challenges over time.Goals in SCI rehabilitation cover a wide range from broad, value-based goals to more specific goals, and the health-care professionals must ensure inclusion of such a wide range of goals.
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Affiliation(s)
- Lisbeth Ørtenblad
- DEFACTUM - Public Health and Rehabilitation Research, Central Denmark Region, Denmark
| | - Thomas Maribo
- DEFACTUM - Public Health and Rehabilitation Research, Central Denmark Region, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Britta Quistgaard
- The Specialized Hospital for Polio- and Accident Victims, Rødovre, Denmark
| | - Ellen Madsen
- The Specialized Hospital for Polio- and Accident Victims, Rødovre, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, Aarhus, Denmark
- The National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Handberg C, Werlauff U. People with neuromuscular diseases and their relatives' perspectives on challenges in everyday life and healthcare. Neurodegener Dis Manag 2023; 13:289-302. [PMID: 38078426 DOI: 10.2217/nmt-2023-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
Objective: People with a neuromuscular disease (NMD) often experience challenges in everyday life and healthcare. Aim: To investigate experiences of and perspectives on challenges in everyday life and healthcare of people with NMDs and their relatives to gain new insights into how life-long rehabilitation can be tailored. Patients & methods: The design was qualitative using the interpretive description methodology and the Sense of Coherence theory. An ethnographic fieldwork was conducted where 45 persons with NMD and their relatives were included for interviews and participant observations. Results & conclusion: People with NMDs continually adapt to a changing functioning and balance their need for knowledge with their dependency on help when navigating the healthcare system. Structured, professionally facilitated peer support is needed.
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Affiliation(s)
- Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, Aarhus C, 8000, Denmark
- Department of Faculty of Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, Aarhus C, 8000, Denmark
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Ørtenblad L, Maribo T, Quistgaard B, Madsen E, Handberg C. Goal-Setting in clinical practice: a study of health-care professionals' perspectives in outpatient multidisciplinary rehabilitation of patients with spinal cord injury. Disabil Rehabil 2023; 45:3330-3341. [PMID: 36137224 DOI: 10.1080/09638288.2022.2125086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 08/29/2022] [Accepted: 09/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Spinal cord injury is a complex condition requiring long-term rehabilitation. Goal-setting is considered an essential part of rehabilitation, however, knowledge of how goal-setting is practised across health-care professions, settings and diagnoses are scarce. The purpose of the study was therefore to explore health-care professionals' perspectives on goal-setting practice in outpatient multidisciplinary rehabilitation targeting patients with spinal cord injury. MATERIALS AND METHODS An anthropological study combining participant-observation and focus group interviews. Data were analysed using reflexive thematic analysis. COREQ checklist was used to report the study quality. RESULTS Health-care professionals experienced a field of tension between internationally recommended goal-setting criteria, requiring goals to be specific, measurable, realistic and time-based, and a practice influenced by patients presenting complex needs. The challenges were managed using a negotiation strategy characterized by a tinkering approach to adjust notions of measurability, realism and time frame into practice. Also, health-care professionals were challenged in relation to practising a person-centred rehabilitation approach. CONCLUSIONS We suggest rethinking the goal-setting process by allowing recommended goal-setting criteria to be adapted to a specific practice context while acknowledging goal-setting practice in its variety and flexibility as a strength. Furthermore, improved incorporation of patients' perspectives in the practice is needed. Implications for rehabilitationTo strengthen person-centred rehabilitation practice, clinicians should actively search for and engage patient-identified needs and preferences in shared goal-setting.Standard criteria of goal-setting should comply with the individual and specific participation in the everyday life of patients with SCI.SMART goals are not always the right way to formulate rehabilitation goals.A flexible and pragmatic approach is needed to reach a balance between the patients' complex needs and the recommendations for goals to be specific, measurable, realistic, and time-based.
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Affiliation(s)
- Lisbeth Ørtenblad
- DEFACTUM - Public Health and Rehabilitation Research, Central Denmark Region, Aarhus, Denmark
| | - Thomas Maribo
- DEFACTUM - Public Health and Rehabilitation Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Britta Quistgaard
- The Specialized Hospital for Polio- and Accident Victims, Rødovre, Denmark
| | - Ellen Madsen
- The Specialized Hospital for Polio- and Accident Victims, Rødovre, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, Aarhus, Denmark
- The National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Lindman A, Handberg C, Olesen G, Duijts S. A multimodal interdisciplinary rehabilitation programme (HAPPY) for patients undergoing allogeneic non-myeloablative haematopoietic stem cell transplantation: A feasibility study. Eur J Oncol Nurs 2023; 65:102339. [PMID: 37327555 DOI: 10.1016/j.ejon.2023.102339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the feasibility of the multimodal interdisciplinary rehabilitation programme HAPPY, targeting patients with haematological malignancy and undergoing allogeneic non-myeloablative haematopoietic stem cell transplantation (NMA-HSCT). METHOD A single arm longitudinal design was applied to test the feasibility of the 6-month HAPPY programme, which consisted of motivational interviewing dialogues, individual supervised physical exercise training, relaxation exercises, nutritional counselling, and home assignments. The feasibility measures included acceptability, fidelity, exposure, practicability, and safety. Descriptive statistics were conducted. RESULTS From November 2018 to January 2020, thirty patients (mean age (SD) 64.1 (6.5)) were enrolled in HAPPY, of whom 18 patients completed the programme. Acceptance was 88%; attrition 40%; fidelity was 80%-100% for all HAPPY elements except phone calls; exposure of HAPPY elements at the hospital reflected individual differences but was acceptable, whereas exposure of HAPPY elements at home was low. Planning of HAPPY for the individual patient was time consuming, and patients were dependent of reminders and incites from the health care professionals. CONCLUSION Most elements of the rehabilitation programme HAPPY were feasible. Yet, HAPPY will benefit from further development and simplifications before an effectiveness study can be conducted, especially regarding improvement of the intervention elements supporting patients at home.
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Affiliation(s)
- Astrid Lindman
- Department of Haematology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark; Department of Public Health, Faculty of Health, Aarhus University, Denmark.
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Denmark; National Rehabilitation Centre for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark.
| | - Gitte Olesen
- Department of Haematology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Saskia Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands; Amsterdam UMC, Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
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Handberg C, Werlauff U. Cross-sectoral collaboration among hospital professionals on rehabilitation for patients with neuromuscular diseases. Neurodegener Dis Manag 2023. [PMID: 36994773 DOI: 10.2217/nmt-2022-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
Introduction: Living with a neuromuscular disease often leads to a need for specialized rehabilitation due to the complexity and progression of the diseases. Aim: To investigate cross-sectoral collaboration on rehabilitation for patients with neuromuscular diseases among hospital professionals to inform future targeted rehabilitation services. Patients & methods: The design was qualitative using the interpretive description methodology and the theoretical lens of symbolic interactionism. Ethnographic fieldwork was conducted, and 50 hospital professionals included, 19 of whom were interviewed. Results & conclusion: The results emphasize the importance of relations when collaborating across sectors. The professionals acted and made choices in relation to dilemmas and influences of diagnosis and progression, professional demarcations in multiprofessional teams, and cross-sectoral collaboration toward a mutual goal.
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Affiliation(s)
- Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, 8000, Aarhus C, Denmark
- Department of Public Health, Aarhus University, 8000, Aarhus C, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, 8000, Aarhus C, Denmark
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Weibel M, Skoubo S, Handberg C, Bertel LB, Steinrud NC, Schmiegelow K, Hallström IK, Larsen HB. Telepresence robots to reduce school absenteeism among children with cancer, neuromuscular diseases, or anxiety—the expectations of children and teachers: A qualitative study in Denmark. Computers in Human Behavior Reports 2023. [DOI: 10.1016/j.chbr.2023.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Allergodt K, Handberg C, Frost A, Werlauff U. A retrospective study of needs and interventions among patients with myotonic dystrophy type 1 in Denmark referred to rehabilitation in the period 2000-2019. J Eval Clin Pract 2023; 29:39-48. [PMID: 35615973 DOI: 10.1111/jep.13706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 05/09/2022] [Accepted: 05/12/2022] [Indexed: 01/21/2023]
Abstract
UNLABELLED RATIONALE, AIMS AND OBJECTIVES: Myotonic dystrophy type 1 (DM1) is a progressive multisystem disorder that requires a special focus on the delivery of health and rehabilitation. The aim of the study was to identify the needs and interventions in patients with DM1 referred to a national rehabilitation hospital and to illustrate the needs and interventions in relation to predefined subgroups of disease classification. METHOD Electronic medical records from the period 2000-2019 of a randomized sample of patients with DM1 (N = 193) were reviewed to identify rehabilitation needs and interventions. The sample was classified into four subgroups of disease classifications. The number of identified needs and interventions were presented as medians and range, and differences between subgroups were illustrated by Kruskal-Wallis one-way analysis of variance. The needs were categorized using the International Classification of Functioning, Disability and Health (ICF). RESULTS A total of 2099 needs and 2103 interventions were registered. The most frequent needs were coordination of healthcare services (480) and employment and income (363), while the most frequent interventions were counselling (835) and follow-up (386). Patients with congenital DM1 had the most needs and interventions per person. In relation to the ICF, the most registered needs were environmental factors (880) and activity and participation (848). CONCLUSION All subgroups of patients with DM1 had a substantial number of needs and interventions related to coordinating and navigating within the healthcare system. The subgroup of patients with congenital DM1 had the most needs and interventions compared to the other subgroups.
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Affiliation(s)
- Kristin Allergodt
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Asger Frost
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Olesen LK, la Cour K, Thorne S, With H, Handberg C. Perceived benefits from peer-support among family caregivers of people with amyotrophic lateral sclerosis and cognitive impairments in a palliative rehabilitation blended online learning programme. J Eval Clin Pract 2023; 29:602-613. [PMID: 36703268 DOI: 10.1111/jep.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
RATIONALE Family caregivers of persons with amyotrophic lateral sclerosis and cognitive and/or behavioural impairments (PALS/CIs) experience various challenges and needs, including emotional and practical support from peers. Various forms of peer-support have shown different strengths and weaknesses; however, little is known about how family caregivers of PALS/CIs interact with and perceive virtual face-to-face peer-support. AIMS AND OBJECTIVES The aim of this study was to understand how caregivers of PALS/CIs interact with and perceive virtual face-to-face peer-support in a palliative rehabilitation programme designed to promote targeted palliative rehabilitation initiatives for caregivers of PALS/CIs. METHOD A qualitative design using participant observations of 17 recorded virtual group-facilitated meetings from two rounds of a 4-month intervention was performed. The Medical Research Council framework, the inductive interpretive description methodology and the theoretical framework of Sense of Coherence guided the study. Nineteen participants, divided into four groups, were included. RESULTS Three themes emerged: 'Relating my situation to others', 'Making room for forbidden thoughts' and 'Longing for normalcy'. The themes reflected the various ways participants interacted in online group meetings and how the interactions evolved around practical, emotional and forbidden thoughts. Sharing personal and sorrowful concerns and frustrations engendered feelings of trust and a sense of belonging, which empowered the participants to address their genuine wish and longing for normalcy with all the trivialities of which ALS/CIs had robbed them. CONCLUSION Virtual face-to-face peer-support can enable caregivers of PALS/CIs to share experiences of everyday life challenges that cannot always be shared elsewhere. Being able to relate to and learn from other's experiences alleviated feelings of loneliness, frustration, and concerns and thereby enhanced comprehensibility, manageability and meaningfulness. Online palliative rehabilitation interventions should provide an opportunity for caregivers to meet regularly in interactive group meetings. Familiarization takes time online and is necessary to improve their sense of feeling safe to share their deepest thoughts. Such group interventions, facilitated by trained healthcare professionals, offer a means to support dynamic group interactions and discussion of sensitive topics.
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Affiliation(s)
- Lene Klem Olesen
- The National Rehabilitation Center for Neuromuscular Diseases, (RCFM), Aarhus, Denmark.,Department of Public Health, Faculty of Health, University of Aarhus, Aarhus, Denmark
| | - Karen la Cour
- Occupational Science, the Research Unit of User Perspectives and Community-based Interventions, University of Southern Denmark, Odense, Denmark
| | - Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Heidi With
- The National Rehabilitation Center for Neuromuscular Diseases, (RCFM), Aarhus, Denmark
| | - Charlotte Handberg
- The National Rehabilitation Center for Neuromuscular Diseases, (RCFM), Aarhus, Denmark.,Department of Public Health, Faculty of Health, University of Aarhus, Aarhus, Denmark
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Ravn MB, Berthelsen C, Maribo T, Nielsen CV, Pedersen CG, Handberg C. Understanding Facilitators and Challenges to Care Transition in Cardiac Rehabilitation: Perspectives and Assumptions of Healthcare Professionals. Glob Qual Nurs Res 2023; 10:23333936231217844. [PMID: 38107551 PMCID: PMC10722928 DOI: 10.1177/23333936231217844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 12/19/2023] Open
Abstract
Cardiac rehabilitation is an essential part of treatment for patients with cardiovascular disease. Cardiac rehabilitation is increasingly organized outside hospital in community healthcare services. However, this transition may be challenging. The aim of this study was to examine assumptions and perspectives among healthcare professionals on how facilitators and challenges influence the transition from hospital to community healthcare services for patients in cardiac rehabilitation. The study followed the Interpretive Description methodology and data consisted of participant observations and focus group interviews. The analysis showed that despite structured guidelines aimed to support the collaboration, improvements could be made. Facilitators and challenges could occur in the collaboration between the healthcare professionals, in the collaboration with the patient, or because of the new reality for patients when diagnosed with cardiovascular disease.
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Affiliation(s)
- Maiken Bay Ravn
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Connie Berthelsen
- Zealand University Hospital, Køge and Roskilde, Denmark
- University of Southern Denmark, Odense, Denmark
| | - Thomas Maribo
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Aarhus University, Denmark
- DEFACTUM Central Denmark Region, Aarhus, Denmark
- Region Hospital Goedstrup, Denmark
| | | | - Charlotte Handberg
- Aarhus University, Denmark
- National Rehabilitation Center for Neuromuscular Diseases; Aarhus, Denmark
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Obro LF, Osther PJS, Ammentorp J, Pihl GT, Krogh PG, Handberg C. Healthcare Professionals' Experiences and Perspectives of Facilitating Self-Management Support for Patients with Low-Risk Localized Prostate Cancer via mHealth and Health Coaching. Int J Environ Res Public Health 2022; 20:346. [PMID: 36612667 PMCID: PMC9819876 DOI: 10.3390/ijerph20010346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Introduction: Self-monitoring of self-management interventions with the use of mobile health (mHealth) can enhance patients' well-being. Research indicates that mHealth and health coaching act symbiotically to providing a more constructive outcome. Nurse coaches seem to have a significant role in translating the patients' tracked data. Objective: The objective was to explore healthcare professionals' experiences of an intervention offering self-management support through mHealth and health coaching for patients with prostate cancer. Methods: We used the interpretive description methodology, combining semi-structured individual and focus group interviews and participant observations of patient-coach interactions and use of mHealth in coaching sessions. The study was conducted between June 2017 and August 2020. Results: The nurse coaches experienced motivation and autonomy when possessing the right competences for coaching. Furthermore, the nurse coaches experienced conflicting expectations of their roles when having to integrate mHealth. Conclusion: The experience of being competent, autonomous, and confident is important for the nurse coaches to be mentally present during the coaching sessions. On the other hand, the findings indicate that having the sense of not being confident in one's own ability to perform leads to reduced motivation.
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Affiliation(s)
- Louise Faurholt Obro
- Urological Research Center, Vejle Hospital—Part of Lillebaelt Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Palle Jörn Sloth Osther
- Urological Research Center, Vejle Hospital—Part of Lillebaelt Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, 5000 Odense, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, 5000 Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | | | - Peter Gall Krogh
- Department of Engineering, Aarhus University, 8200 Aarhus, Denmark
| | - Charlotte Handberg
- The National Rehabilitation Center for Neuromuscular Diseases, 8000 Aarhus, Denmark
- Department of Public Health, Faculty of Health, Aarhus University, 8000 Aarhus, Denmark
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Pedersen ML, Handberg C, Dreyer P. Mental health reported in adult invasive home mechanical ventilation through a tracheostomy: A scoping review. International Journal of Nursing Studies Advances 2022. [DOI: 10.1016/j.ijnsa.2022.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mahoney AF, Handberg C. New medicine for neuromuscular diseases: An evolving paradox for patient and family hopes and expectations. Nurs Inq 2022; 30:e12527. [PMID: 36115015 DOI: 10.1111/nin.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 08/19/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Recent developments in novel therapies for neuromuscular diseases offer parents new perspectives on their affected children's future. This article examines how the emergence of new therapies impacts the lives of parents of children with Duchenne muscular dystrophy or spinal muscular atrophy type 2, two genetic neuromuscular disorders characterized by progressive muscle degeneration. Aiming for a first-person perspective, fieldwork was conducted utilizing participant observation, semistructured interviews, and several internet sources. Six families with a total of 12 persons, all living in Denmark, were included in the interviews. Two types of parents were identified who were at opposite ends in dealing with the new therapies-the cure optimists and the cure pragmatists. Different hopes resulted in different narratives for their children's futures. The article raises questions about how and when children with chronic diseases should be involved in their parent's hopes for a cure and highlights the dilemmas facing health professionals working in the field of children with chronic diseases for which the prospects of a cure are improving. We conclude that health professionals must find a way to carefully balance guidance and information about experimental medicines, including the fact that experimental medicine sometimes fails, does not work as well as hoped for, or does not become available, with sustaining parental hopes for their children's future.
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Affiliation(s)
- Annette F. Mahoney
- National Rehabilitation Centre for Neuromuscular Diseases Aarhus Denmark
| | - Charlotte Handberg
- National Rehabilitation Centre for Neuromuscular Diseases Aarhus Denmark
- Department of Public Health Aarhus University Aarhus Denmark
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Handberg C, Werlauff U. Cross-sectorial collaboration on policy-driven rehabilitation care models for persons with neuromuscular diseases: reflections and behavior of community-based health professionals. BMC Health Serv Res 2022; 22:1168. [PMID: 36114488 PMCID: PMC9482251 DOI: 10.1186/s12913-022-08557-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 09/09/2022] [Indexed: 11/27/2022] Open
Abstract
Background Persons with neuromuscular diseases (NMDs) often experience complex rehabilitation needs due to the disease’s impact on their functioning and progression of their diseases. As a consequence of legislation and “policy power”, community-based health professionals function as gatekeepers to the rehabilitation trajectory for persons with NMDs in a field where the other professionals are the specialists. Aim To investigate community-based health professionals’ reflections on and behaviors regarding collaboration with a tertiary rehabilitation hospital in a cross-sectorial rehabilitation care model with the overall aim of providing high quality rehabilitation for persons with NMD. Methods The design is qualitative and uses interpretive description methodology and the theoretical lens of Edgar Schein’s three levels of organizational culture and leadership. An ethnographic fieldwork was conducted from September 1, 2019 to January 30, 2020. Eighty-four community-based health professionals were included and 17 of them were interviewed in four semi-structured focus group interviews (n = 10) and seven individual interviews (n = 7). In addition, 151 pages of observation data were generated. The study adheres to the COREQ guidelines. Results The analysis showed three themes of importance for the collaboration: Policy and legislation navigation represented that collaboration on rehabilitation was affected by legislation as a management tool with “the case” as the core element, and goal dilemmas. Cross-sectorial knowledge exchange promoted collaboration on coordinated and facilitated rehabilitation and knowledge sharing as a firm anchoring. Patient ownership negotiations implied collaboration was influenced by knowledge founded power and gatekeeping as a navigation tool. Conclusion Three levels of organizational culture and leadership were identified, and this overall structure guided the community-based health professionals in their work and in the complex organizational landscape of collaboration between disconnected healthcare systems. The findings provided insight into behavior and attitudes and the content and the values held by the professionals collaborating across sectors. Future collaboration in rehabilitation models should be multiprofessional and team based. The findings emphasize that it is imperative that managements and professionals strive to strengthen the structure of the collaborative team spirit because this will ensure well-planned, coordinated, and conducted rehabilitation for persons with NMD and enable and support future cross-sectorial collaboration in this rehabilitation model for these persons.
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16
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Obro LF, Osther PJS, Ammentorp J, Pihl GT, Heiselberg KK, Krogh PG, Handberg C. An Intervention Offering Self-management Support Through mHealth and Health Coaching to Patients With Prostate Cancer: Interpretive Description of Patients’ Experiences and Perspectives. JMIR Form Res 2022; 6:e34471. [PMID: 35925751 PMCID: PMC9501670 DOI: 10.2196/34471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Observational management strategies such as active surveillance and watchful waiting are considered to be acceptable approaches in patients with low-risk localized prostate cancer and a safe alternative to aggressive treatment. During observational management, treatment is postponed until the disease progresses, which often never occurs. However, approximately 90% of patients with a low-risk disease choose aggressive treatment owing to anxiety. Strategies to address anxiety are needed for optimal management of this population and to improve the quality of life of patients with low-risk localized prostate cancer. A review highlighted that mobile health (mHealth) in tandem with health coaching can support patients’ self-management of health behaviors and improve well-being.
Objective
This study aims to explore patients’ experiences with and perspectives on an intervention offering self-management support through the use of mHealth devices and health coaching to identify supportive features that enable patients to perform sustainable changes that improve well-being.
Methods
We used an interpretive description approach, combining semistructured interviews with 13 purposively selected patients with prostate cancer and participant observations of patient-coach interactions in coaching sessions. The interviews were transcribed and analyzed. The self-determination theory was used as a theoretical lens. Field notes and coaching notes from each session were used to orient data generation and confirm or challenge the analysis.
Results
Our analysis suggested that patients’ self-awareness and psychological identity influenced their experiences with and perspectives on the self-management support offered by mHealth and health coaching in clinical practice. The patients’ individual experiences and perspectives indicated that they placed themselves in a dynamic continuum of sustaining or repressing their identity, self-awareness, and individual qualities. Our analysis revealed 4 interacting themes, all related to the psychological identity of the patients.
Conclusions
For the group of patients with prostate cancer to experience well-being, we found it important for them to sustain their self-image when offered a self-management intervention. Motivation and autonomy were important aspects for the individual patients to sustain their self-image throughout the intervention. In contrast, demotivation and a sense of paternalism could result in fostering an experience of having to repress self-awareness.
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Affiliation(s)
- Louise Faurholt Obro
- Urological Research Center, Vejle Hospital (Lillebaelt Hospital), University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Palle Jörn Sloth Osther
- Urological Research Center, Vejle Hospital (Lillebaelt Hospital), University Hospital of Southern Denmark, Vejle, Denmark
- Department of Regional Health Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Jette Ammentorp
- Centre for Research in Patient Communication, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Kasper Kvols Heiselberg
- Urological Research Center, Vejle Hospital (Lillebaelt Hospital), University Hospital of Southern Denmark, Vejle, Denmark
- Department of Engineering, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | | | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
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17
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Olesen LK, la Cour K, With H, Mahoney AF, Handberg C. A cross-sectional evaluation of acceptability of an online palliative rehabilitation program for family caregivers of people with amyotrophic lateral sclerosis and cognitive and behavioral impairments. BMC Health Serv Res 2022; 22:697. [PMID: 35610609 PMCID: PMC9128325 DOI: 10.1186/s12913-022-07986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) is a progressive fatal neurodegenerative disease. Around half of the population with ALS develop cognitive and/or behavioral impairment. Behavioral changes in persons with ALS are perceived as the strongest predictor of psychosocial distress among family caregivers. Interventions aiming to support family caregivers are emphasized as important in relation to reducing psychological distress among family caregivers. Successful healthcare interventions depend on the participants' acceptance of the intervention. Therefore, this study aims to evaluate the acceptability of a new online palliative rehabilitation blended learning program (EMBRACE) for family caregivers of people with ALS and cognitive and/or behavioral impairments. METHODS A qualitative cross-sectional design using the theoretical framework of acceptability to evaluate acceptance of the intervention based on data collected through individual in-depth interviews and participant observations. Individual interviews were conducted in 10 participants post-intervention and participant observations were recorded during virtual group meetings among 12 participants. A deductive retrospective analysis was used to code both datasets in relation to the seven constructs of the theoretical framework of acceptability: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. The theory of sense of coherence by Antonovsky informed the development and design of the intervention and interviews. The study adheres to the COREQ (consolidated criteria for reporting qualitative research) guidelines. RESULTS Within the seven constructs we found that affective attitude addressed the meaning and importance of peer support and focused on the participants' needs and challenges. Burden referred to technology challenges, time pressure, and frequent interruptions during meetings. Ethicality concerned transparency about personal experiences and the exposure of the affected relative. Intervention coherence referred to a shared destiny among participants when they shared stories. Opportunity costs primary concerned work-related costs. Perceived effectiveness referred to the usefulness and relevance of peer support and the meetings that brought up new ideas on how to approach current and future challenges. Self-efficacy involved the motivation to learn more about ALS and ways to cope that were accommodated by the convenient online format. CONCLUSIONS The findings showed that the participants favored peer support and the videos that reduced feelings of loneliness and frustration but also confronted them and provided knowledge on future challenges. Further research should explore the benefits of the program and the meaning of online peer support among caregivers of people with ALS and cognitive and/or behavioral impairments. TRIAL REGISTRATION Retrospectively registered on November 20th, 2020. ID no. NCT04638608 .
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Affiliation(s)
- Lene Klem Olesen
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark, Denmark. .,Department of Public Health, Faculty of Health, Aarhus University, Vennelyst Boulevard 4, 8000, Aarhus, Denmark.
| | - Karen la Cour
- Research Unit of User Perspectives and Community-Based Interventions, University of Southern Denmark, W.P Windslovparken 15-19, 5000, Odense, Denmark
| | - Heidi With
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark, Denmark
| | - Annette Faber Mahoney
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark, Denmark
| | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Vennelyst Boulevard 4, 8000, Aarhus, Denmark
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18
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Olesen LK, la Cour K, With H, Handberg C. Reflections of family caregivers and health professionals on the everyday challenges of caring for persons with amyotrophic lateral sclerosis and cognitive impairments: a qualitative study. Palliat Care Soc Pract 2022; 16:26323524221077702. [PMID: 35187490 PMCID: PMC8855464 DOI: 10.1177/26323524221077702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/13/2022] [Indexed: 11/25/2022] Open
Abstract
Aims and objectives: To explore reflections of family caregivers and health professionals
regarding the challenges involved in caring for persons with amyotrophic
lateral sclerosis and cognitive and/or behavioral impairments
(PALS/CIs). Background: Family caregivers of PALS/CIs are highly burdened and at great risk of
psychological sequela. Professionals working with these families can be
negatively affected on their well-being and are at risk of burnout. Design: The design was a qualitative interview study. Methods: One focus group and 10 individual semi-structured interviews were conducted
with seven family caregivers and nine professionals after the death of a
PALS/CIs. The analysis was guided by the interpretive description
methodology and the theory of sense of coherence. This study adheres to the
COREQ guidelines and the ICMJE recommendations. Results: The family caregivers’ challenges regarding coping with everyday needs
related to the sick person were associated with ‘Accepting that nothing else
matters’, ‘Adjusting to new roles while balancing’, and ‘Realizing different
values in relationships’; whereas the professionals’ challenges were related
to ‘Collaboration a balancing act’, ‘Working in a home of sorrow’, and
‘Coordinating threads to tie’. Conclusion: Family caregivers found coping with the complexity of the diseases a
challenge, and their everyday life needed constant adjustment to new roles,
coping with inappropriate behavior, and navigating through the progression
of the diseases of their sick relatives while collaborating with numerous
professionals. The professionals struggled with coordinating and
collaborating with the families and with other colleagues due to the
severeness and complexity of diseases. Relevance to clinical practice: Findings point to the importance of relationships for caregivers and
professionals and a need to provide support through an online palliative
rehabilitation program that encompass coping strategies in relation to the
diseases. Trial registration details: Id no. NCT 04638608.
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Affiliation(s)
- Lene Klem Olesen
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Kongsvang Allé 23, 8000 Aarhus, Denmark
| | - Karen la Cour
- Research Unit of User Perspectives, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Heidi With
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Aarhus, Denmark
| | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases (RCFM), Aarhus, Denmark
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19
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Gamskjaer T, Werlauff U, Handberg C. Investigating job satisfaction in palliative rehabilitation: Reflections and perspectives of health professionals working with amyotrophic lateral sclerosis. J Eval Clin Pract 2022; 28:108-119. [PMID: 34269500 DOI: 10.1111/jep.13599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022]
Abstract
STUDY RATIONALE Amyotrophic lateral sclerosis is a progressive neurodegenerative disease which causes impairment of the motor functions in the upper and lower limbs and bulbar muscles with a median survival time is three years from the first appearance of symptoms. There is massive psychological impact on health professionals to persons with amyotrophic lateral sclerosis, hence the work leads to multiple challenges and stressful and demanding situations with high risk of experiencing diminished personal well-being including burnout, moral distress, and compassion fatigue. AIM To investigate reflections and perspectives from health professionals working within palliative rehabilitation for elements of importance in relation to job satisfaction. METHODS AND MATERIALS The design was qualitative and based on the phenomenological-hermeneutical methodology by Paul Ricoeur's interpretation theory. Data consisted of two semi-structured focus group interviews with a total of 12 specialized health professionals: Nurses, Psychologists, Physicians, Occupational Therapists, Physiotherapists, and Social workers, working within a hospital setting of specialized palliative rehabilitation for people with amyotrophic lateral sclerosis and their families. RESULTS The analysis revealed insight into four themes: fundamental drive, working conditions, value of collegiality and work-life balance. Fundamental drive was deeply rooted in the professionals' sense of having a meaningful job. Working conditions such as self-management were important for job satisfaction as were good collegial relations. Finally, a good balance between working life and private life was considered important for job satisfaction. CONCLUSION Our study indicates that work within the field of palliative rehabilitation is experienced as enriching and beneficial under the right circumstances and in an appreciatory working environment. We found elements like autonomy, mastery, purpose, collegiality, and work-life balance to be of great importance. Our findings can help guide managements and health professionals in other palliative rehabilitation contexts to ensure satisfied employees and to optimize the quality of care.
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Affiliation(s)
- Tine Gamskjaer
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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20
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Handberg C, Werlauff U, Højberg AL. Perspectives on Everyday Life Challenges of Danish Young People With Duchenne Muscular Dystrophy (DMD) on Corticosteroids. Glob Qual Nurs Res 2022; 9:23333936221094858. [PMID: 35493771 PMCID: PMC9052227 DOI: 10.1177/23333936221094858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 12/03/2022] Open
Abstract
This study aimed to investigate perspectives on everyday life challenges of young persons with Duchenne muscular dystrophy in Denmark treated with corticosteroids perceived by young persons and their parents to improve rehabilitation interventions. Nineteen semi-structured interviews were conducted: 10 individual interviews with 10 persons with DMD and six individual interviews with parents (five mothers and one father) and three couple interviews (three mothers and three fathers). The analysis was guided by interpretive description methodology and Antonovsky’s Sense of Coherence theory. The results indicated that persons with Duchenne muscular dystrophy existed in a flux between experiencing greater Sense of Coherence revolving around normality and less Sense of Coherence exposing their vulnerability which unfolded in four opposing themes: (1) bodily ability and disability, (2) content and anxious, (3) sociable and lonely, and (4) independent and dependent. Future rehabilitation should aim at supporting resistance resources promoting bodily ability, being content, sociable, and independent.
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Affiliation(s)
- Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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21
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Bøgdal J, Schmidt AM, Nielsen KØ, Handberg C. An Integrated Multidisciplinary Rehabilitation Program Experienced by Patients with Chronic Low Back Pain. Clin Med Res 2021; 19:192-202. [PMID: 34933952 PMCID: PMC8691428 DOI: 10.3121/cmr.2021.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 05/11/2021] [Accepted: 05/11/2021] [Indexed: 11/18/2022]
Abstract
Purpose: To examine how an integrated, multidisciplinary rehabilitation program was experienced by patients with chronic low back pain and to gain insight into how these patients integrated knowledge, skills, and behaviors obtained by the program into their everyday lives.Materials and Methods: A phenomenological hermeneutic design using Ricoeur's interpretation theory was used in the analysis. Data were generated through nine semi-structured interviews in patients with chronic low back pain. The study adhered to the Consolidated criteria for reporting qualitative research (COREQ) checklist.Results: Standardized rehabilitation efforts adapted to individual needs and provided by a highly professional healthcare team in a combination of inpatient stay and home-based activities was experienced as beneficial, because the patients were able to integrate the obtained knowledge, skills, and behaviors into their everyday lives.Conclusions: The findings revealed that the multidisciplinary holistic approach led to higher bodily awareness, greater mental health, and increased social interaction, which improved happiness and quality of life among the patients. This study emphasizes and highlights a rehabilitation approach that promotes home-based activities to provide a base for co-creation across professions regarding rehabilitation initiatives for patients with chronic low back pain.
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Affiliation(s)
- Julie Bøgdal
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark.
| | - Anne Mette Schmidt
- Sano, Højbjerg, Denmark
- Diagnostic Centre, University Clinic for Innovative Patient Pathways, Regional Hospital Silkeborg, Silkeborg, Denmark
| | | | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus C, Denmark
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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22
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Obro LF, Handberg C, Ammentorp J, Pihl GT, Heiselberg K, Krogh PG, Osther PJS. Prostate cancer patients' perspectives of integrating
mHealth
and coaching in prostate cancer survivorship care. Int J Urol Nurs 2021. [DOI: 10.1111/ijun.12281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Louise Faurholt Obro
- Urological Research Center, Vejle Hospital, Lillebaelt Hospital University Hospital of Southern Denmark Vejle Denmark
- Department of Regional Health Research, Faculty of Health Sciences University of Southern Denmark Odense Denmark
| | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases Aarhus Denmark
- Department of Public Health, Faculty of Health Aarhus University Aarhus Denmark
| | - Jette Ammentorp
- Department of Regional Health Research, Faculty of Health Sciences University of Southern Denmark Odense Denmark
- Centre for Patient Communication Odense University Hospital Odense Denmark
| | | | - Kasper Heiselberg
- Urological Research Center, Vejle Hospital, Lillebaelt Hospital University Hospital of Southern Denmark Vejle Denmark
- Department of Engineering Aarhus University Aarhus Denmark
- Steno Diabetes Center Aarhus Aarhus University Hospital Aarhus Denmark
| | | | - Palle Jörn Sloth Osther
- Urological Research Center, Vejle Hospital, Lillebaelt Hospital University Hospital of Southern Denmark Vejle Denmark
- Department of Regional Health Research, Faculty of Health Sciences University of Southern Denmark Odense Denmark
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23
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Faurholt Obro L, Heiselberg K, Gall Krogh P, Handberg C, Ammentorp J, Thybo Pihl G, Jörn Sloth Osther P. Corrigendum to "Combining mHealth and health-coaching for improving self-management in chronic care. A scoping review" [Patient Educ Couns, 104, 4 (April 2021) 680-688]. Patient Educ Couns 2021; 104:2601. [PMID: 34229918 DOI: 10.1016/j.pec.2021.06.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Louise Faurholt Obro
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Kasper Heiselberg
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Department of Engineering, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark; Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Palle Jörn Sloth Osther
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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24
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Lindman A, Handberg C, Olesen G, Duijts S. Health-related quality of life and physical functioning in patients participating in a rehabilitation programme, undergoing non-myeloablative allogeneic haematopoietic stem cell transplantation: Outcomes from a single arm longitudinal study. Eur J Cancer Care (Engl) 2021; 30:e13478. [PMID: 34263492 DOI: 10.1111/ecc.13478] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 05/07/2021] [Accepted: 05/19/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study aims to report HRQOL, patient activation and physical functioning of haematological patients, participating in a 6-month multimodal interdisciplinary rehabilitation programme HAPPY, when undergoing non-myeloablative allogeneic haematopoietic stem cell transplantation (NMA-HSCT). METHODS A prospective single-arm longitudinal design. Outcomes were collected as part of a feasibility study and included: HRQOL (EORTC QLQ-C30), patient activation measure (PAM), cardiorespiratory capacity (VO2peak ), leg extensor power, lean body mass, measured pre-NMA-HSCT at 3-, 6- and 12-month follow-up. RESULTS Thirty (mean age (SD) 64.1 (6.5)) out of 34 patients participated and 18 completed HAPPY. Outcome measures showed large individual differences of decline and improvement during follow-up. Patients rated HRQOL as good (median 70.8; range 33.3-100). Fatigue, dyspnoea, insomnia and appetite loss mainly remained or worsened. PAM stayed in the upper half of range (median 55.6; range 20.5-84.8) with a trend towards improvement at 12-month follow-up. Physical functioning scores were low [i.e. baseline VO2peak , men median 1.5 L/min range (1.0-2.9), women 1.0 L/min (0.8-1.4), leg extensor power men 2.1 Watt/kg range (1.3-3.8), women 1.7 Watt/kg (1.3-2.4), lean body mass men 19.5% (17.6-24.9) and women 17.8% (15.3-21.7)]. CONCLUSION The sustained low level of physical functioning and symptoms 12-month after NMA-HSCT emphasise the need for pre-rehabilitation and long-lasting rehabilitation support in this frail patient group.
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Affiliation(s)
- Astrid Lindman
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Gitte Olesen
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | - Saskia Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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25
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Handberg C, Werlauff U, Højberg AL, Knudsen LF. Impact of the COVID-19 pandemic on biopsychosocial health and quality of life among Danish children and adults with neuromuscular diseases (NMD)-Patient reported outcomes from a national survey. PLoS One 2021; 16:e0253715. [PMID: 34191825 PMCID: PMC8244874 DOI: 10.1371/journal.pone.0253715] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/10/2021] [Indexed: 12/30/2022] Open
Abstract
The purpose was to investigate the impact of the COVID-19 pandemic on biopsychosocial health, daily activities, and quality of life among children and adults with neuromuscular diseases, and to assess the prevalence of COVID-19 infection and the impact of this in patients with neuromuscular diseases. The study was a national questionnaire survey. Responses were obtained from 811 adults (29%) and 67 parents of children (27%) with neuromuscular diseases. Many patients reported decreased health or physical functioning, and changes in access to physiotherapy or healthcare due to the pandemic. Participants generally perceived themselves or their child to be at high risk of severe illness from COVID-19, but only 15 patients had suffered from COVID-19 and experienced mild flu-like symptoms. 25.3% of adults and 46.6% of parents experienced anxiety. 20.4% of adults and 27.6% of parents experienced symptoms of depression. In general, the pandemic contributed to anxiety, a depressed mood as well as to fewer leisure activities, less social contact, isolation from work/school and a reduced quality of life, in particular for patients who perceived themselves to be at high risk of severe illness. The results demonstrate that the pandemic has had a negative impact on biopsychosocial health and quality of life of patients with neuromuscular diseases.
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Affiliation(s)
- Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Ulla Werlauff
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | | | - Lone F. Knudsen
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Madsen LS, Poulsen DV, Nielsen CV, Handberg C. "It Was Definitely an Eye-Opener to Me"-People with Disabilities' and Health Professionals' Perceptions on Combining Traditional Indoor Rehabilitation Practice with an Urban Green Rehabilitation Context. Int J Environ Res Public Health 2021; 18:ijerph18115994. [PMID: 34204913 PMCID: PMC8199774 DOI: 10.3390/ijerph18115994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
Research points to the health benefits of rehabilitation in urban green spaces. Nevertheless, more studies indicate complexity of utilising urban green spaces in an established health system context. An understanding of challenges related to rehabilitation in urban green spaces remains unaddressed. Therefore, the aim was to describe and analyse people with disabilities' and health professionals' perceptions on combining traditional indoor rehabilitation practice with an urban green rehabilitation context. The interpretive description methodology was applied supplemented by Edgar Schein's Model of Organisational Culture. Three online focus group interviews were conducted with people with disabilities (n = 4) and health professionals (n = 10). Three interrelated themes formed an understanding of rehabilitation practice in an urban green rehabilitation context: "ambivalence due to contextual change", "negotiating rehabilitation assumptions" and "expanding the frame of rehabilitation". Expanding the frame of rehabilitation to an urban green context may provide a basis for enhancing compatibility to everyday life for people with disabilities and still accommodate structural quality standards of professional rehabilitation practice.
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Affiliation(s)
- Louise Sofia Madsen
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Correspondence:
| | - Dorthe Varning Poulsen
- Department of Geosciences and Natural Resource Management, University of Copenhagen, 1958 Frederiksberg, Denmark;
| | - Claus Vinther Nielsen
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- DEFACTUM, Central Denmark Region, 8000 Aarhus, Denmark
- Regional Hospital West Jutland, Central Denmark Region, 7400 Herning, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark; (C.V.N.); (C.H.)
- National Rehabilitation Centre for Neuromuscular Diseases, 8000 Aarhus, Denmark
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Faymonville L, Schmidt AM, Handberg C. Implementation of a multidisciplinary rehabilitation program for patients with chronic low back pain-experiences and perspectives of rehabilitation team members. J Eval Clin Pract 2021; 27:377-384. [PMID: 32720754 DOI: 10.1111/jep.13441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022]
Abstract
STUDY RATIONALE Low back pain is a common condition and one of the leading reasons for years of chronic disability. Rehabilitation has been shown to be effective on low back pain, because it is based on the complex and multifactorial mechanisms that low back pain entails. AIM The aim of this study was to describe and interpret rehabilitation team members' experiences and perspectives regarding an integrated rehabilitation program for patients with chronic low back pain. METHODS AND MATERIALS This qualitative study used the Interpretive Description methodology. Data consisted of participant observation of 28 rehabilitation team members and four semi-structured focus group interviews with 20 of the 28 participants. The COREQ checklist was used to consolidate the findings in the study. RESULTS The results represented an insight into rehabilitation team members' experiences and perspectives regarding the implementation of an integrated rehabilitation program for patients with chronic low back pain. The significance of the rehabilitation team members' expectations was underlined as they initially had positive expectations but along the implementing of the program found their expectations challenged. The challenges they experienced were related to their professional competence, the incongruity of the two programs being compared, and to their utilization of quick fixes. CONCLUSION This Interpretive Description study provides insight into the complexity and challenges related to implementation practice. It identifies important elements when implementing a new rehabilitation intervention in clinical practice and emphasizes the importance of expectations among rehabilitation team members in the implementation process. There should be a specific focus on the importance of involving rehabilitation team members when new interventions are to be implemented, as participation contributes to increased positivity in relation to new initiatives.
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Affiliation(s)
- Lisa Faymonville
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Central Denmark Region, Denmark
| | - Anne Mette Schmidt
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Central Denmark Region, Denmark.,SANO, Aarhus, Central Denmark Region, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Central Denmark Region, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Central Denmark Region, Denmark
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Seibaek L, Handberg C, Beedholm K. 'Well, if I don't show up and go through with the fertility treatment, I won't have a baby'; Patient involvement in clinical practice: Option or condition? J Eval Clin Pract 2021; 27:256-263. [PMID: 32652735 DOI: 10.1111/jep.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Worldwide, the concept of patient involvement has a growing impact on health care. Involvement in care represents a benefit to many patients, but while being involved is inevitable for the patient, we assume that getting involved is not in all cases obtainable. On this background, we aimed to investigate patients' perceptions and experiences concerning their treatment and care in a clinical fertility treatment setting, and discuss how these may influence their possibilities for involvement in care. METHOD Based on findings from focus-group interviews with women undergoing fertility treatment, we have dealt with two aspects that impact the patients' possibilities for getting involved in their care: Imbalanced power relations in clinical settings, and patients' experiences of their physical vulnerability. Framed by phenomenological-hermeneutic text interpretation theory key condensations were analysed and critically discussed. RESULTS We found that (a) to the individual patient it did not represent a free choice to seek and undergo treatment; (b) patients experienced substantial dependency, vulnerability, and anxiety during their clinical pathway. CONCLUSION We conclude that it is essential to integrate also the influence of the clinical setting and the bodily aspects of care in the understanding of patient involvement in clinical practice.
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Affiliation(s)
- Lene Seibaek
- Department of Gynaecology and Obstetrics, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University and National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Kirsten Beedholm
- Department of Public Health, Nursing, Aarhus University, Aarhus, Denmark
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Obro LF, Heiselberg K, Krogh PG, Handberg C, Ammentorp J, Pihl GT, Osther PJS. Combining mHealth and health-coaching for improving self-management in chronic care. A scoping review. Patient Educ Couns 2021; 104:680-688. [PMID: 33143907 DOI: 10.1016/j.pec.2020.10.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/14/2020] [Accepted: 10/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Self-management approaches are widely used to improve chronic care. In this context, health care professionals call for efficient tools to engage patients in managing their illness. Mobile health (mHealth), defined by WHO as medical and public health practice supported by mobile devices, is demonstrated to enhance self-management and health-coaching as an engaging tool in supporting behaviour change. Nevertheless, it is unclear how health-coaching and mHealth can benefit from each other. OBJECTIVE We conducted a scoping review to provide a literature-overview and identify any existing gaps in knowledge of mHealth in combination with health-coaching interventions for improving self-management in patients with chronic diseases. PATIENT INVOLVEMENT No patients were involved in the review process. METHODS The five-stage framework by Arksey and O'Malley was used. The review surveys; PubMed, CINAHL, Embase, Scopus, and PsycInfo. Two independent reviewers performed review selection and characterization. RESULTS The review points at two approaches; (i) coaching used to support mHealth and (ii) mHealth as support for coaching. The findings suggest that patients prefer physical interactions to telecommunication. mHealth was primarily used to facilitate telecommunication and to monitor disease aspects. DISCUSSION We found that mHealth and health-coaching interventions benefit from each other. The review report on a considerable unclarity in the coaching-methods and that the patients were more satisfied with physical interactions than mHealth. We suggest to prioritize human contact and to explore more personalized health technology. PRACTICAL VALUE This scoping review can provide a framework for researchers and care providers to support discussion and introduction of new approaches and technology in self-management for patients with chronic diseases, thereby improving patients' quality of life.
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Affiliation(s)
- Louise Faurholt Obro
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark.
| | - Kasper Heiselberg
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Department of Engineering, Aarhus University, Aarhus, Denmark; Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark
| | | | - Charlotte Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark; Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | | | - Palle Jörn Sloth Osther
- Urological Research Center, Lillebaelt Hospital, Vejle, Denmark; Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
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Madsen LS, Jakubec SL, V Nielsen C, Handberg C. The potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation. Disabil Rehabil 2021; 44:3992-4003. [PMID: 33749467 DOI: 10.1080/09638288.2021.1897887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: The aim was to examine the potential of outdoor contexts within community-based rehabilitation to empower people with disabilities in their rehabilitation.Materials and methods: Interpretive description was applied as the methodology in a 5-month ethnographic fieldwork study, and guided by social practice theory. In total, 115 people with disabilities were included for participant observation, of which 15 participants were recruited for individual walking interviews.Results: Analysis revealed four overlapping themes. Firstly, "Revisiting the Outdoors" appeared to be an overarching theme, which created a basis for "Building Autonomy" among the participants. The varied outdoor experiences empowered the participants to take a more active role in their rehabilitation. These experiences afforded unique opportunities for "Connecting with Community" and, finally, "Embodied Learning" - that could be transferred to home and to other everyday contexts.Conclusion: Outdoor contexts within community-based rehabilitation appeared to hold strong potential for connecting people with disabilities to communities. Although barriers exist, we argue that revisiting the outdoors supports collective awareness and action with the capacity to influence community attitudes more broadly.IMPLICATIONS FOR REHABILITATIONOutdoor contexts within community-based rehabilitation for people with disabilities capitalise on the features of both indoor and outdoor environments with activities that meet shifting individual priorities and needs.Outdoor contexts within community-based rehabilitation offer people with disabilities empowering experiences that are part of the landscape of everyday life and transfer well to home and other environments.Community-based rehabilitation directly involving outdoor contexts and supported by professional skills provides a crucial bridge from individual rehabilitation to community belonging.
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Affiliation(s)
- Louise S Madsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Sonya L Jakubec
- School of Nursing and Midwifery, Mount Royal University, Calgary, Canada
| | - Claus V Nielsen
- Department of Public Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,Region Hospital West Jutland, Central Denmark Region, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Centre for Neuromuscular Diseases, Aarhus, Denmark
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Madsen LS, Nielsen CV, Oliffe JL, Handberg C. Navigating a Middle Ground - Exploring Health Professionals' Experiences and Perceptions of Providing Rehabilitation in Outdoor Community Settings. Qual Health Res 2021; 31:41-53. [PMID: 32880512 DOI: 10.1177/1049732320951771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Contemporary practice has started to rethink use of outdoor and community environments for advancing comprehensive rehabilitation outcomes. The aim is to examine health professionals' experiences and perceptions of providing rehabilitation in outdoor community settings. The purpose is to use these experiences to generate practice-based knowledge in using the outdoors as a means to guide community-based rehabilitation. The Interpretive Description methodology was accompanied by social practice theory. Fieldwork was conducted utilizing participant observation, photovoice, and focus-group interviews. Included were 27 health professionals. The analysis revealed how "naturalistic learning opportunities" offered health professionals strategies to empower activity and participation levels and yet invoked "rehabilitation setting tensions." A continuum was engaged in the theme "navigating a middle ground," representing an integrated environment approach; rehabilitation in conventional indoor and outdoor community settings. Development of a sustainable concept for outdoor community-based rehabilitation involves strengthening health professionals' competencies and skills for providing outdoor and community work.
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Affiliation(s)
| | - Claus V Nielsen
- Aarhus University, Aarhus, Denmark
- DEFACTUM, Aarhus, Denmark
- Region Hospital West Jutland, Holstebro, Denmark
| | - John L Oliffe
- The University of British Columbia, Vancouver, British Columbia, Canada
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Charlotte Handberg
- Aarhus University, Aarhus, Denmark
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Handberg C, Maribo T. Why cancer survivorship care needs assessment may lead to no clear patient pathway - Based on patients' experiences and perspectives. Eur J Oncol Nurs 2020; 48:101824. [DOI: 10.1016/j.ejon.2020.101824] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/17/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
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Handberg C, Myrup P, Højberg AL. "I was worried about not being good enough". Experiences and perspectives on pregnancy, childbirth and parenthood when living with a neuromuscular disorder - an exploration of everyday life challenges. Disabil Rehabil 2020; 44:1821-1829. [PMID: 32805149 DOI: 10.1080/09638288.2020.1804628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of this study was to explore the everyday life experiences and perspectives on challenges related to pregnancy, childbirth and parenthood when living with neuromuscular disorders (NMDs) and identify important elements to take into consideration for parents and their health professionals. MATERIALS AND METHODS In all, 27 people (17 with a NMD and 10 partners without a NMD) were included in this study. The participants were all parents or expecting parents. Both mothers and fathers and ambulant and non-ambulant participants were included to broaden the perspective. Three types of semi-structured interviews were applied. The analysis was guided by the Interpretive Description methodology and Antonovsky's Sense of Coherence theory. RESULTS The findings illuminated insights to ongoing challenges in the everyday lives of parents with NMD. Enforced Dilemmas represented guilt and dilemmas on the possibility of passing on the NMD. Reflections on Bodily Ability symbolized the effect that pregnancy and parenthood had on the body. Concept of Normality signified the concerns the parents had about "not being normal enough." Experience of Dependency addressed being dependent on others and No One to Emulate how the rarity of the NMD made it difficult to find peers or seek advice. CONCLUSION The study emphasizes the importance of the professionals providing counseling and support on pregnancy, childbirth, and parenthood either during consultations, online or in structured professional and peer-support rehabilitation groups for expecting parents or for new parents with a NMD.IMPLICATIONS FOR REHABILITATIONProfessionals must provide knowledge and counselling on pregnancy, childbirth, and parenthood to support families with NMD who are expecting a child or have already become parents and address the illusion of normal.Professional centralized and specialized units where people with NMD can get advice on pregnancy and give birth should be an option.Structured professional and peer-support rehabilitation groups (physical meetings or online) on pregnancy, childbirth, and parenthood may be of value for the parents due to the rarity of the diagnosis.Online information and knowledge on pregnancy, childbirth, and parenthood and NMD should be widely available.Health professionals and peers can help ensure and support an experience of comprehensibility, manageability, and meaningfulness among the parents with NMD and develop rehabilitation services that meet the needs and preferences of people considering getting a child or who are already parents with NMDs or other disabilities.
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Affiliation(s)
- C Handberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark.,Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - P Myrup
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - A-L Højberg
- National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Maribo T, Jensen CM, Madsen LS, Handberg C. Experiences with and perspectives on goal setting in spinal cord injury rehabilitation: a systematic review of qualitative studies. Spinal Cord 2020; 58:949-958. [PMID: 32424174 DOI: 10.1038/s41393-020-0485-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/28/2020] [Accepted: 04/30/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Systematic review of qualitative studies. OBJECTIVE To synthesise qualitative research exploring the experiences and perspectives of persons with spinal cord injury (SCI), relatives and health professionals concerning goal setting in SCI rehabilitation. METHODS Five electronic databases were searched. A search strategy was constructed with key concepts identified using PICo (Population, phenomena of Interest and Context). Peer reviewed studies complying with the inclusion criteria were selected. Interpretive Description methodology guided analysis and synthesis of the findings. RESULTS The search yielded 427 records. Of 12 full text studies assessed for eligibility, four were included describing goal setting in SCI rehabilitation from the perspective of persons with SCI and health professionals. Persons with SCI described a need for goal setting to be related to their everyday life, whereas the health professionals tended to use the hospital setting as their point of reference. Persons with SCI emphasised the importance of being self-directed and taking an active role in goal setting and rehabilitation. No studies presented the perspective of relatives. CONCLUSIONS This review illuminates the divergence in the understanding of goal setting between persons with SCI and health professionals. Goal setting in SCI rehabilitation often directly reflects physical functioning goals set by the health professionals, which does not prepare persons with SCI for everyday life and emotional issues. There is lack of focus on goals addressing psychosocial components such as family issues and change of roles. A shared process with goal setting relevant to persons with SCI and their everyday life is needed.
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Affiliation(s)
- Thomas Maribo
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark. .,DEFACTUM, Central Denmark Region, Aarhus, Denmark.
| | - Charlotte Maria Jensen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,The Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark
| | - Louise Sofia Madsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Ibsen C, Schiøttz-Christensen B, Maribo T, Nielsen CV, Hørder M, Handberg C. "Keep it simple": Perspectives of patients with low back pain on how to qualify a patient-centred consultation using patient-reported outcomes. Musculoskeletal Care 2019; 17:313-326. [PMID: 31430043 DOI: 10.1002/msc.1417] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Patient-reported outcomes are expected to play an important role in patient-centred health care. To capture patients' perspectives, patient involvement in the development of patient-reported outcome (PRO) instruments is essential, but often lacking. This qualitative study explored the perspectives of patients with low back pain, to gain an understanding of how to qualify a patient-centred consultation by using PROs. This was done by exploring patients' perspectives regarding the assessment of functioning and disability as part of the development of a new PRO instrument based on the International Classification of Functioning, Disability and Health Core Set. METHODS Semi-structured focus group interviews with seven patients with low back pain were conducted. Data were analysed by drawing on the Interpretive Description methodology. RESULTS The analysis revealed three core themes: simplicity, individuality and application. Simplicity represented keeping items to a minimum and avoiding overlaps; individuality implied the need for individualized answers; and application signified that PROs should be utilized during the consultation, and that they can provide useful information for clinical decision-making. CONCLUSIONS The study provides essential knowledge about elements of importance to patients with low back pain when aiming for a patient-centred consultation using PROs. Furthermore, it underlines the importance of involving patients in PRO development because their perspectives improved the new PRO instrument.
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Affiliation(s)
- Charlotte Ibsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt, Middelfart, Denmark
- Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Thomas Maribo
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Claus Vinther Nielsen
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Mogens Hørder
- Institute of Public Health, Unit of User Perspectives, University of Southern Denmark, Odense, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark
- The Danish National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Witte H, Handberg C. An assessment of survivorship care needs of patients with colorectal cancer: The experiences and perspectives of hospital nurses. J Clin Nurs 2019; 28:4310-4320. [PMID: 31294502 DOI: 10.1111/jocn.14995] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/30/2019] [Accepted: 06/30/2019] [Indexed: 01/24/2023]
Abstract
PURPOSE To describe and analyse hospital nurses' experiences and perspectives of needs assessment in relation to colorectal cancer patients' survivorship care and rehabilitation needs. METHOD The methodology and design of this study was phenomenological-hermeneutic, and the analysis was performed by Ricoeur's theory of interpretation. Twelve hospital nurses working within the care of patients with colorectal cancer participated in four focus group interviews between February-March 2018. Focus group interviews were recorded, transcribed and analysed. The study adhered to the COREQ checklist. RESULTS Our analysis showed that nurses experienced challenges and barriers in conducting needs assessment. These challenges were described in three main themes. Encountering paradigms brought to light the difficulties relating to implementation of needs assessment into daily practice in the complex context of a hospital setting. Patient involvement could be challenging because of insufficient involvement and inadequate health literacy of patients in relation to needs assessment. A negative attitude towards systematic needs assessment among nurses could present a barrier because of their role as gatekeepers. CONCLUSION The findings point to important elements that are necessary to consider when planning cancer survivorship care in the hospital setting so that all patients experience the best possible cancer trajectory. These insights can guide future clinical practice in the endeavour to ensure more systematic initiatives towards cancer rehabilitation. RELEVANCE TO CLINICAL PRACTICE Based on our findings, cancer survivorship care needs assessment in the hospital setting should encompass specific guidelines on needs assessment and systematic implementation of these guidelines by involving hospital management, nurses and patients through use of visionary information and communication. Implementation of these guidelines would be supported by securing knowledge on cancer survivorship care for all hospital health professionals. Health literacy should be considered in formulating guidelines that enhance involvement of patients by use of patient-centred communication.
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Affiliation(s)
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,The Danish National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
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Handberg C, Svendsen ML, Maribo T. A Cross-Sectional Study Evaluating Potential Differences in the Need for Cancer Survivorship Care in Relation to Patients' Socioeconomic Status. J Clin Med Res 2019; 11:515-523. [PMID: 31236171 PMCID: PMC6575116 DOI: 10.14740/jocmr3871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/29/2019] [Indexed: 12/15/2022] Open
Abstract
Background There seems to be inequity within cancer survivorship care in primary care settings related to gender, shorter education, and early poor health, but there is uncertainty regarding the character of the needs in hospital and in primary care settings and whether there is inequity regarding meeting these needs. This study aims to describe potential differences in needs among patients in hospital and in primary care settings, and to assess the need for survivorship care and rehabilitation in patients with cancer in relation to socioeconomic status. Methods In a cross-sectional study including patients in hospital (n = 89) and primary care settings (n = 99), information from needs assessments was linked with population-based data on socioeconomic status via unique personal identification numbers. The association between socioeconomic status and stated needs was analyzed separately for patients in hospital and primary care settings, with adjustment for age and gender. Results A total of 90% patients expressed one or more needs in the physical area, 51% in the emotional area, and 40% in the practical area. Patients in primary care expressed more needs than patients in hospital. Men expressed more needs than women in primary care (adjusted odds ratio (OR) (95% confidence interval (CI)): 2.66 (1.04 - 6.79)). The results indicate that higher socioeconomic status is associated with fewer stated needs. Conclusions This study suggests that the association between gender and stated needs may depend on healthcare setting and confirms that higher socioeconomic status in relation to civil status, educational level, income, and labor market status is associated with fewer stated needs.
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Affiliation(s)
- Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark.,The Danish National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | | | - Thomas Maribo
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Aarhus, Denmark
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Brandenbarg D, Maass SWMC, Geerse OP, Stegmann ME, Handberg C, Schroevers MJ, Duijts SFA. A systematic review on the prevalence of symptoms of depression, anxiety and distress in long-term cancer survivors: Implications for primary care. Eur J Cancer Care (Engl) 2019; 28:e13086. [PMID: 31087398 PMCID: PMC9286037 DOI: 10.1111/ecc.13086] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 04/16/2019] [Accepted: 04/20/2019] [Indexed: 01/17/2023]
Abstract
Introduction Symptoms of depression, anxiety and distress are common in the first years after a cancer diagnosis, but little is known about the prevalence of these symptoms at the long term. The aim of this review was to describe the prevalence of symptoms of depression, anxiety and distress in long‐term cancer survivors, five or more years after diagnosis, and to provide implications for primary care. Methods We performed a systematic literature search in the PubMed, PsycINFO and CINAHL databases. Studies were eligible when reporting on the prevalence of symptoms of depression, anxiety and/or distress in long‐term cancer survivors (≥5 years after diagnosis), treated with curative intent. Results A total of 20 studies were included. The reported prevalence of depressive symptoms (N = 18) varied from 5.4% to 49.0% (pooled prevalence: 21.0%). For anxiety (N = 7), the prevalence ranged from 3.4% to 43.0% (pooled prevalence: 21.0%). For distress (N = 4), the prevalence ranged from 4.3% to 11.6% (pooled prevalence: 7.0%). Conclusion Prevalences of symptoms of depression, anxiety and distress among long‐term survivors of cancer do not fundamentally differ from the general population. This is reassuring for primary care physicians, as they frequently act as the primary physician for long‐term survivors whose follow‐up schedules in the hospital have been completed.
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Affiliation(s)
- Daan Brandenbarg
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Saskia W M C Maass
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Olaf P Geerse
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mariken E Stegmann
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Aarhus, Denmark.,The Danish National Rehabilitation Center for Neuromuscular Diseases, Aarhus, Denmark
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Saskia F A Duijts
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Lykke S, Handberg C. Experienced Loneliness in Home-Based Rehabilitation: Perspectives of Older Adults With Disabilities and Their Health Care Professionals. Glob Qual Nurs Res 2019; 6:2333393619831661. [PMID: 30859114 PMCID: PMC6402052 DOI: 10.1177/2333393619831661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 01/05/2019] [Accepted: 01/09/2019] [Indexed: 11/16/2022] Open
Abstract
This study aimed to describe and interpret perspectives of older adults with disabilities and their health care professionals (HCPs) on experienced loneliness during home-based rehabilitation. The interpretive description methodology guided the study. Data included semistructured individual interviews with seven older adults and a focus group interview with three HCPs. The analysis revealed four main findings that symbolized experienced loneliness. “Unspoken pain” and “gatekeeping emotions” concerning experienced loneliness as a taboo and stigma during rehabilitation were closely connected. “Resignation” and “awaiting company” signified the consequences of experienced loneliness when not addressed. Unspoken pain, gatekeeping emotions, resignation, and awaiting company were dominating experiences in the lives of the older adults during a home-based rehabilitation program following disability. This had restrained them from verbalizing and coping with loneliness during rehabilitation and life in general. The HCPs’ attempt to provide support for the older adults in coping with loneliness appeared to be characterized by gatekeeping emotions and keeping hidden agendas.
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40
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Lindman A, Krintel Petersen A, Olesen G, Handberg C. Patients´ experiences and perspectives of challenges and needs related to nonmyeloablative stem cell transplantation: Involving patients in developing a targeted rehabilitation programme. J Clin Nurs 2019; 28:1260-1272. [PMID: 30552726 DOI: 10.1111/jocn.14739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/22/2018] [Accepted: 12/05/2018] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To explore patients' experiences and perspectives of their challenges and needs regarding their return to everyday life after allogeneic nonmyeloablative haematopoietic stem cell transplantation (NMA-HSCT). BACKGROUND NMA-HSCT can cure patients with malignant blood diseases, but during the following years, the majority of patients suffer from serious side effects and complications. Hence, it is a major challenge for patients treated with NMA-HSCT to rehabilitate, maintain physical and psychosocial functioning and return to a life in restored balance. DESIGN The design was qualitative using the interpretive description methodology, and the theoretical framework symbolic interactionism inspired the interview guide and analysis. METHODS Between April to May 2017, five focus group interviews were conducted with 15 outpatients in a haematological ward in Denmark. The patients were treated with NMA-HSCT 8-30 months prior to the interviews. The study adheres to the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS The impaired functioning was the overarching theme and seemed to be the trigger entailing rehabilitation needs related to the following main themes: realising decline, adapting to changes, the meaning of motivation and reliance on relations. These findings seemed to affect and influence the patients' struggle for a return to an everyday life like before being diagnosed or just before undergoing NMA-HSCT. CONCLUSION This study adds to our understanding of important elements to consider when developing a targeted rehabilitation programme. RELEVANCE TO CLINICAL PRACTICE Based on our findings, the rehabilitation programme should encompass: extensive variation regarding how to address the impaired functioning through individualised approaches, multimodal interventions, interventions through several months with varying intensity, an interdisciplinary team approach supporting motivation and visualisation of every progress by tangible goal setting, communication regarding hope and support, extended supportive care for patients living alone and finally increased adherence through social sessions with relatives and fellow patients.
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Affiliation(s)
- Astrid Lindman
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Annemette Krintel Petersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Physiotherapy and Occupational Therapy, Aarhus University, Aarhus, Denmark.,Centre of Research in Rehabilitation (CORIR), Aarhus University Hospital & Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Gitte Olesen
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
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Abstract
Purpose: To describe and analyse social interactions among the users, partners and stakeholders involved in developing a rehabilitation park to determine a future approach to community-based rehabilitation.Materials and methods: The design was qualitative using the methodology interpretive description and symbolic interactionism as the theoretical framework. Data was generated through a two-year ethnographic fieldwork throughout the development of the SPARK (Sound Park Activities Rehabilitation and Climate) rehabilitation park. The participants were users, partners, and stakeholders of the park and data consisted of participant observations comprising observations, informal conversations, and field notes.Results: Three themes formed an understanding of the significance of involvement; A shared vision reflected the participants' joint overall idea for the rehabilitation park containing possibilities for health promotions for everyone. Perceived solidarity represented an experience of a project where everyone's opinion counted whilst Profound Acknowledgement signified a state of a deeper experience of being valued and heard.Conclusions: The findings suggest consistent and continuous involvement of users, partners, and stakeholders, creating possibilities for co-creation in rehabilitation in new settings. The development of rehabilitation parks like the SPARK park in a shared public arena may benefit people with disability, and everyone and further help reduce stigma around disability.Implications for RehabilitationThe rehabilitation definition forms the base for co-creation of rehabilitation initiatives among people in need of rehabilitation as such and professionals with different approaches and professions.Conducting rehabilitation practice in a shared outdoor arena may provide professional development and expansion towards interdisciplinary approaches across diagnoses and professions.Outdoor rehabilitation may (despite different target groups) function as a facilitator for professional and chance meetings in the park and thereby create a community for meeting across professional disciplines, founding, and enabling a practice that allows to reflect on and learn from different approaches within rehabilitation.Community-based rehabilitation in a public shared arena may generate possibilities for reducing stigma towards people with disability.
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Affiliation(s)
- Charlotte Handberg
- Department of Public Health, Centre for Rehabilitation, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Aarhus, Denmark.,DEFACTUM, Central Denmark Region, Vibrog, Denmark
| | - Ole Mygind
- Marselisborg Centre, Danish Centre for Rehabilitation - Research and Development, Aarhus, Denmark
| | - Jan Sau Johansen
- Marselisborg Centre, Danish Centre for Rehabilitation - Research and Development, Aarhus, Denmark
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Handberg C, Midtgaard J, Nielsen CV, Thorne S, Lomborg K. Healthcare Professionals' Attitudes to Rehabilitation Programming for Male Cancer Survivors. Rehabil Nurs 2018; 43:127-137. [PMID: 27766645 DOI: 10.1002/rnj.298] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study is to describe and interpret the attitudes and conduct of hospital healthcare professionals (HCPs) in association with male cancer survivors and their municipal rehabilitation participation. DESIGN Ethnographic fieldwork was conducted, consisting of participant observation and nine semistructured focus group interviews with 58 hospital HCPs. METHODS Using interpretive description methodology with symbolic interaction as a theoretical framework, data were collected through fieldwork in three oncology wards in Denmark. FINDINGS Attitudes about both gender and rehabilitation were identified as overarching obstructions within hospital HCP conduct toward promoting men's participation in cancer rehabilitation. CONCLUSIONS Gender and rehabilitation perceptions formed barriers in this context, suggesting that male cancer survivors' rehabilitation outcomes may be compromised by HCP attitudes and conduct. CLINICAL RELEVANCE These findings provide insight into approaches to guide HCPs to take responsibility for rehabilitation and to take gender into account in their work.
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Madsen LS, Jeppesen J, Handberg C. “Understanding my ALS”. Experiences and reflections of persons with amyotrophic lateral sclerosis and relatives on participation in peer group rehabilitation. Disabil Rehabil 2018; 41:1410-1418. [DOI: 10.1080/09638288.2018.1429499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Louise Sofia Madsen
- Department of Public Health, Faculty of Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Denmark
| | - Jørgen Jeppesen
- The National Rehabilitation Centre for Neuromuscular Diseases, Aarhus, Denmark
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Section for Clinical Social Medicine and Rehabilitation, Aarhus University, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Denmark
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44
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Handberg C. Implementing Augmentative and Alternative Communication in Critical Care Settings. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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45
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Nielsen CV, Handberg C, Madsen LS. Rehabilitation in a New Context - A PhD Research Protocol. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- CV Nielsen
- Aarhus University, Faculty of Health and DEFACTUM, Central Region Denmark, Aarhus, Denmark
| | - C Handberg
- Aarhus University, Faculty of Health and DEFACTUM, Central Region Denmark, Aarhus, Denmark
| | - LS Madsen
- Aarhus University, Faculty of Health and DEFACTUM, Central Region Denmark, Aarhus, Denmark
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Handberg C, Jensen CM, Maribo T. Lack of Needs Assessment in Cancer Survivorship Care and Rehabilitation in Hospitals and Primary Care Settings. J Clin Med Res 2017; 9:864-871. [PMID: 28912923 PMCID: PMC5593434 DOI: 10.14740/jocmr3160w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 08/25/2017] [Indexed: 11/21/2022] Open
Abstract
Background Formalized and systematic assessment of survivorship care and rehabilitation needs is prerequisite for ensuring cancer patients sufficient help and support through their cancer trajectory. Patients are often uncertain as to how to express and address their survivorship care and rehabilitation needs, and little is known about specific, unmet needs and the plans necessary to meet them. There is a call for both ensuring survivorship care and rehabilitation for cancer patients in need and further for documenting the specific needs related to the cancer disease and its treatment. Thus the aim of this study was to describe specific survivorship care and rehabilitation needs and plans as stated by patients with cancer at hospitals when diagnosed and when primary care survivorship care and rehabilitation begins. Methods Needs assessment forms from cancer patients at two hospitals and two primary care settings were analyzed. The forms included stated needs and survivorship care and rehabilitation plans. All data were categorized using the International Classification of Functioning, Disability and Health (ICF). Results Eighty-nine patients at hospitals and 99 in primary care, stated their needs. Around 50% of the patients completed a survivorship care and rehabilitation plan. In total, 666 (mean 7.5) needs were stated by hospital patients and 836 (mean 8.0) by those in primary care. The needs stated were primarily within the ICF component “body functions and structure”, and the most frequent needs were (hospitals/primary care) fatigue (57%/67%), reduced muscle strength (55%/67%) and being worried (37%/36%). Conclusions The results underpin an urgent need for a systematic procedure to assess needs in clinical practice where cancer patients are being left without survivorship care and rehabilitation needs assessment. Gaining knowledge on needs assessment and the detailed description of needs and plans can facilitate targeted interventions. The findings indicate an urgent need to change the practice culture to be systematic in addressing and identifying survivorship care needs among patients with cancer. Further the findings call for considering the development of a new needs assessment form with involvement of both patients and healthcare professionals.
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Affiliation(s)
- Charlotte Handberg
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
| | - Charlotte Maria Jensen
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
| | - Thomas Maribo
- Department of Public Health, Section for Clinical Social Medicine and Rehabilitation, Faculty of Health, Aarhus University, Denmark.,DEFACTUM, Central Denmark Region, Denmark
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Handberg C, Voss AK. Implementing augmentative and alternative communication in critical care settings: Perspectives of healthcare professionals. J Clin Nurs 2017; 27:102-114. [DOI: 10.1111/jocn.13851] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Charlotte Handberg
- Department of Public Health; Section for Clinical Social Medicine and Rehabilitation; Faculty of Health; Aarhus University; Aarhus Denmark
- DEFACTUM; Aarhus Central Denmark Region Denmark
| | - Anna Katarina Voss
- Technology in Practice; MarselisborgCenter; Danish Centre for Rehabilitation - Research and Development; Aarhus Denmark
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Handberg C, Beedholm K, Bregnballe V, Nellemann AN, Seibaek L. Reflections on patient involvement in research and clinical practice: A secondary analysis of women's perceptions and experiences of egg aspiration in fertility treatment. Nurs Inq 2017; 25. [DOI: 10.1111/nin.12210] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Charlotte Handberg
- Department of Public Health; Section for Clinical Social Medicine and Rehabilitation; Faculty of Health; Aarhus University; Aarhus Denmark
| | - Kirsten Beedholm
- Department of Public Health; Section for Nursing; Faculty of Health; Aarhus University; Aarhus Denmark
| | - Vibeke Bregnballe
- Department of Clinical Medicine; Faculty of Health; Aarhus University; Aarhus Denmark
| | | | - Lene Seibaek
- Department of Gynaecology and Obstetrics; Aarhus University Hospital; Aarhus Denmark
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Maribo T, Petersen KS, Handberg C, Melchiorsen H, Momsen AMH, Nielsen CV, Leonardi M, Labriola M. Systematic Literature Review on ICF From 2001 to 2013 in the Nordic Countries Focusing on Clinical and Rehabilitation Context. J Clin Med Res 2016; 8:1-9. [PMID: 26668676 PMCID: PMC4676339 DOI: 10.14740/jocmr2400w] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 11/23/2022] Open
Abstract
We present a systematic review on International Classification of Functioning, Disability and Health (ICF) used in the Nordic countries from 2001 through 2013, describing and quantifying the development in utilization of ICF, and describe the extent to which the different components of the ICF have been used. A search was conducted in EMBASE, MEDLINE and PsycInfo. Papers from Nordic countries were included if ICF was mentioned in title or abstract. Papers were assigned to one of eight categories covering the wide rehabilitation area; furthermore, area of focus was assigned. Use of ICF components and intervention were coded in papers categorized as "clinical and/or rehabilitation contexts" or "non-clinical contexts". One hundred seventy papers were included, of these 99 papers were from the categories "clinical and/or rehabilitation contexts" or "non-clinical contexts". Forty-two percent of the 170 included papers were published in the period 2011 - 2013. There was an increase in ICF-relevant papers from 2001 to 2013, especially in the categories "clinical and/or rehabilitation contexts" and "non-clinical contexts". The most represented focus areas were neurology, musculoskeletal, and work-related areas. All five or at least four ICF components were mentioned in the results or discussions in most papers, and activity was most frequently mentioned.
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Affiliation(s)
- Thomas Maribo
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Kirsten S. Petersen
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Charlotte Handberg
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Hanne Melchiorsen
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | | | - Claus V. Nielsen
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
| | - Matilde Leonardi
- Neurology Public Health and Disability Unit, Neurological Institute C. Besta, IRCCS Foundation, Milan, Italy
| | - Merete Labriola
- Section of Social Medicine and Rehabilitation, Department of Public Health, Rehabilitation Center Marselisborg, Aarhus University, Denmark
- Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark
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Handberg C, Thorne S, Midtgaard J, Nielsen CV, Lomborg K. Revisiting Symbolic Interactionism as a Theoretical Framework Beyond the Grounded Theory Tradition. Qual Health Res 2015; 25:1023-32. [PMID: 25316693 DOI: 10.1177/1049732314554231] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The tight bond between grounded theory (GT) and symbolic interactionism (SI) is well known within the qualitative health research field. We aimed to disentangle this connection through critical reflection on the conditions under which it might add value as an underpinning to studies outside the GT tradition. Drawing on an examination of the central tenets of SI, we illustrate with a field study using interpretive description as methodology how SI can be applied as a theoretical lens through which layers of socially constructed meaning can help surface the subjective world of patients. We demonstrate how SI can function as a powerful framework for human health behavior research through its capacity to orient questions, inform design options, and refine analytic directions. We conclude that using SI as a lens can serve as a translation mechanism in our quest to interpret the subjective world underlying patients' health and illness behavior.
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Affiliation(s)
| | - Sally Thorne
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie Midtgaard
- Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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