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Hajdarevic, S., Norberg, A., Lundman, B. & Hörnsten, Å. (2024). Becoming whole again-Caring for the self in chronic illness-A narrative review of qualitative empirical studies. Journal of Clinical Nursing
Open this publication in new window or tab >>Becoming whole again-Caring for the self in chronic illness-A narrative review of qualitative empirical studies
2024 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702Article in journal (Refereed) Epub ahead of print
Abstract [en]

AIM AND OBJECTIVES: To explore how chronic illness transforms the self when living with and managing chronic illness and what this means for their self and identity. We also discuss how people with chronic conditions could be supported by healthcare professionals to manage illness in daily life.

BACKGROUND: Self-management recommendations from health care are commonly based on a biomedical understanding of the disease. People's experiences of how a condition affects them and adequate support are crucial for their outcomes in daily self-management.

DESIGN: A narrative review.

METHODS: A systematic search was undertaken during January 2021 across the databases MEDLINE, CINAHL, PsycINFO, Soc INDEX and Philosopher's Index. A quality appraisal of articles was performed. Our analysis was inspired by qualitative content analysis. The PRISMA Checklist 2020/EQUATOR guidelines was used to report the study.

RESULTS: Twenty-eight peer-reviewed qualitative empirical articles focusing on self in a variety of chronic illnesses with relevance to nursing published from January 2010 to December 2020 were included. The main theme, Developing from an uncertain existence to meaning and wholeness, was built up by the five themes: Walking on an unstable ground; Being stalemated; Being involved with others for better or worse; Searching for meaning; and lastly, Modifying self and integrating a new way of living.

CONCLUSIONS: The results illuminate experiences that seldom are prioritized but need to be addressed by health professionals. Such experiences are oriented more towards the existential self rather than medical issues, why it is important to go beyond the medical lens.

RELEVANCE TO CLINICAL PRACTICE: This is important knowledge for nurses aiming to support people with chronic illnesses. Nurses supporting people in self-management need to be aware that by teaching and encouraging people to revise their daily habits, they also work on the boundaries of their self-concept.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
chronic illness, nursing, review, self, self‐management
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-226794 (URN)10.1111/jocn.17332 (DOI)38886987 (PubMedID)
Available from: 2024-06-20 Created: 2024-06-20 Last updated: 2024-06-20
Hällgren Graneheim, U., Lindgren, B.-M. & Lundman, B. (2023). Kvalitativ innehållsanalys (3ed.). In: Maria Henricson (Ed.), Vetenskaplig teori och metod: från idé till examination inom vård- och hälsovetenskap (pp. 295-312). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Kvalitativ innehållsanalys
2023 (Swedish)In: Vetenskaplig teori och metod: från idé till examination inom vård- och hälsovetenskap / [ed] Maria Henricson, Lund: Studentlitteratur AB, 2023, 3, p. 295-312Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2023 Edition: 3
National Category
Nursing
Research subject
health services research; Caring Sciences; caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-218335 (URN)9789144161389 (ISBN)
Available from: 2023-12-19 Created: 2023-12-19 Last updated: 2023-12-28Bibliographically approved
Viglund, K., Olofsson, B., Lundman, B., Norberg, A. & Lövheim, H. (2022). Relationships among inner strength, health and function, well-being, and negative life events in old people: a longitudinal study. European Journal of Ageing, 19, 545-554
Open this publication in new window or tab >>Relationships among inner strength, health and function, well-being, and negative life events in old people: a longitudinal study
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2022 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, p. 545-554Article in journal (Refereed) Published
Abstract [en]

Inner strength is a conceptualization of a human resource that is generally considered beneficial for health and well-being. Previously, it has been examined in qualitative and cross-sectional studies, but longitudinal data are lacking. The aim of this study was to examine how inner strength, health and function, well-being, and negative life events, namely crises and diseases, affect each other over time in old people. A longitudinal two-wave design was used with data from 2010 and 2016. A total of 4023 participants, living in Finland and Sweden, and born in 1930, 1935, 1940, or 1945 were included. Data were collected using the Inner Strength Scale, the Life Orientation Scale, a short version of the Geriatric Depression Scale, one item from the SF36, and five items from the Katz ADL-index. Structural equation modeling was used to test for cross-lagged effects. Crises and diseases were found to be a positive predictor of inner strength, a negative predictor of well-being, and to have no significant effect on health and function over time. Inner strength and well-being had a reciprocal positive relationship, and health and function was a positive predictor inner strength. The study expands findings by providing perspectives of inner strength across time indicating that inner strength in old people increases when they have to face a disease or crisis. From a health perspective, the present findings reinforce the importance of healthcare professionals' awareness and knowledge of the construct of inner strength.

Place, publisher, year, edition, pages
Springer, 2022
Keywords
Cross-lagged panel model, Disease, Health, Inner strength, Longitudinal, Well-being
National Category
Nursing Geriatrics
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-188684 (URN)10.1007/s10433-021-00642-6 (DOI)000708325700001 ()34690625 (PubMedID)2-s2.0-85117168816 (Scopus ID)
Funder
Swedish Research Council, K2104- 99X-22610-01-6
Available from: 2021-10-19 Created: 2021-10-19 Last updated: 2022-12-06Bibliographically approved
Hammarström, A., Lundman, B. & Norberg, A. (2021). The importance of having a paid job: Gendered experiences of health and ill-health in daily life among middle-aged women and men. BMC Public Health, 21(1), Article ID 2023.
Open this publication in new window or tab >>The importance of having a paid job: Gendered experiences of health and ill-health in daily life among middle-aged women and men
2021 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 2023Article in journal (Refereed) Published
Abstract [en]

Background: More gender-theoretical studies are needed to gain a deeper understanding of what life circumstances make people sick or improve their health. The aim of the study was to gain a deeper understanding of social determinants of health by exploring gendered experiences in daily life among middle-aged women and men using the theory of gender relations.

Methods: Individual interviews with nine men and women were performed, focusing on what made them feel good or bad. Qualitative content analysis was used to analyse the data.

Results: A major theme in our interviews was the gendered health-promoting experiences related to having a job, which involved becoming someone, feeling appreciated at work and having control over work. Having good family relations was also health-promoting, in terms of supportive relations and becoming a parent. Ill-health was related to gendered adverse conditions at work (accidents, monotonous and stressful work tasks, being bullied) and in domestic life (demands, destructive partner relations, having children with problems).

Conclusions: Gendered determinants of health and ill-health were identified in both working and domestic life. Public health policy needs to challenge the gender order in society, which defines the gendered structure of the labour market as well as the gendered relations in domestic life.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Domestic work, Gender relations, Paid work, Social determinants of health
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-189615 (URN)10.1186/s12889-021-12034-7 (DOI)000715034600006 ()34742259 (PubMedID)2-s2.0-85118711139 (Scopus ID)
Funder
Swedish Research Council Formas, 259–2012-37Region VästerbottenForte, Swedish Research Council for Health, Working Life and Welfare, 2011–0445
Available from: 2021-11-17 Created: 2021-11-17 Last updated: 2023-08-28Bibliographically approved
Lindgren, B.-M., Lundman, B. & Hällgren Graneheim, U. (2020). Abstraction and interpretation during the qualitative content analysis process. International Journal of Nursing Studies, 108, Article ID 103632.
Open this publication in new window or tab >>Abstraction and interpretation during the qualitative content analysis process
2020 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 108, article id 103632Article in journal (Refereed) Published
Abstract [en]

Qualitative content analysis and other ‘standardised’ methods are sometimes considered to be technical tools used for basic, superficial, and simple sorting of text, and their results lack depth, scientific rigour, and evidence. To strengthen the trustworthiness of qualitative content analyses, we focus on abstraction and interpretation during the analytic process. To our knowledge, descriptions of these concepts are sparse; this paper therefore aims to elaborate on and exemplify the distinction and relation between abstraction and interpretation during the different phases of the process of qualitative content analysis. We address the relations between abstraction and interpretation when selecting, condensing, and coding meaning units and creating categories and themes on various levels. The examples used are based on our experiences of teaching and supervising students at various levels. We also highlight the phases of de-contextualisation and re-contextualisation in describing the analytic process. We argue that qualitative content analysis can be both descriptive and interpretative. When the data allow interpretations of the latent content, qualitative content analysis reveals both depth and meaning in participants’ utterances.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
Abstraction, De-contextualisation, Interpretation, Qualitative content analysis, Re-contextualisation
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-171534 (URN)10.1016/j.ijnurstu.2020.103632 (DOI)000541257000011 ()32505813 (PubMedID)2-s2.0-85085769949 (Scopus ID)
Available from: 2020-06-04 Created: 2020-06-04 Last updated: 2023-03-23Bibliographically approved
Lundman, B., Hammarström, A., Ahlgren, C. & Norberg, A. (2019). Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults. SAGE Open Medicine, 7
Open this publication in new window or tab >>Use of the model of Inner Strength for analysing reflective interviews in a group of healthy middle-aged adults
2019 (English)In: SAGE Open Medicine, E-ISSN 2050-3121, Vol. 7Article in journal (Refereed) Published
Abstract [en]

Objective: Inner Strength has been described as a human resource that promotes well-being linked to health. The aim of this study was to explore how Inner Strength and its four dimensions are manifested in interviews in a group of middle-aged healthy women and men.

Methods: Retrospective reflective interviews with middle-aged healthy women (n = 5) and men (n = 4) selected from a population study were content analysed deductively.

Results: The following themes and their constituents were found in the respective dimensions of the Model of Inner Strength. Firmness: having a drive to act, being purposeful, having trust in one’s competence, and having a positive view of life. Connectedness: being in community, receiving and giving support, and, receiving and giving care. Creativity: changing unsatisfactory life situations, seeing new opportunities, and realizing dreams. Stretchability: balancing between options, and extending oneself.

Conclusions: Expressions that were interpreted as belonging to Inner Strength could be referred the different dimensions of Inner Strength. The Model of Inner Strength is suitable for analysing Inner Strength among middle-aged men and women. The findings indicate that Inner Strength can be identified in human beings’ narratives if asked for.

Place, publisher, year, edition, pages
SAGE Open, 2019
Keywords
Nursing, mental health, psychiatry, Inner Strength, content analysis, deductive
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-161455 (URN)10.1177/2050312119856812 (DOI)000471113000001 ()31217970 (PubMedID)2-s2.0-85116882818 (Scopus ID)
Funder
Swedish Research Council Formas, 259-2012-37
Available from: 2019-07-10 Created: 2019-07-10 Last updated: 2023-03-24Bibliographically approved
Lindelöf, N., Lundin-Olsson, L., Skelton, D. A., Lundman, B. & Rosendahl, E. (2017). Experiences of older people with dementia participating in a high-intensity functional exercise program in nursing homes: "While it's tough, it's useful". PLOS ONE, 12(11), Article ID e0188225.
Open this publication in new window or tab >>Experiences of older people with dementia participating in a high-intensity functional exercise program in nursing homes: "While it's tough, it's useful"
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2017 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 11, article id e0188225Article in journal (Refereed) Published
Abstract [en]

The objective of the study was to describe the views and experiences of participation in a high-intensity functional exercise (HIFE) program among older people with dementia in nursing homes. The study design was a qualitative interview study with 21 participants (15 women), aged 74-96, and with a Mini-Mental State Examination score of 10-23 at study start. The HIFE-program comprises exercises performed in functional weight-bearing positions and including movements used in everyday tasks. The exercise was individually designed, supervised in small groups in the nursing homes and performed during four months. Interviews were performed directly after exercise sessions and field notes about the sessions were recorded. Qualitative content analysis was used for analyses. The analysis revealed four themes: Exercise is challenging but achievable; Exercise gives pleasure and strength; Exercise evokes body memories; and Togetherness gives comfort, joy, and encouragement. The intense and tailored exercise, adapted to each participant, was perceived as challenging but achievable, and gave pleasure and improvements in mental and bodily strength. Memories of previous physical activities aroused and participants rediscovered bodily capabilities. Importance of individualized and supervised exercise in small groups was emphasized and created feelings of encouragement, safety, and coherence. The findings from the interviews reinforces the positive meaning of intense exercise to older people with moderate to severe dementia in nursing homes. The participants were able to safely adhere to and understand the necessity of the exercise. Providers of exercise should consider the aspects valued by participants, e.g. supervision, individualization, small groups, encouragement, and that exercise involved joy and rediscovery of body competencies.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2017
National Category
Physiotherapy Nursing Geriatrics
Identifiers
urn:nbn:se:umu:diva-142971 (URN)10.1371/journal.pone.0188225 (DOI)000415646100030 ()29149198 (PubMedID)2-s2.0-85034242263 (Scopus ID)
Available from: 2017-12-14 Created: 2017-12-14 Last updated: 2023-03-24Bibliographically approved
Boman, E., Lundman, B., Nygren, B., Årestedt, K. & Santamäki Fischer, R. (2017). Inner strength and its relationship to health threats in ageing: a cross-sectional study among community-dwelling older women. Journal of Advanced Nursing, 73(11), 2720-2729
Open this publication in new window or tab >>Inner strength and its relationship to health threats in ageing: a cross-sectional study among community-dwelling older women
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2720-2729Article in journal (Refereed) Published
Abstract [en]

Aim: To explore the relationship between inner strength and health threats among community-dwelling older women. Background: Inner strength is described as a resource that promotes experiences of health, despite adversities. Inner strength and its dimensions (i.e. connectedness, creativity, firmness and flexibility) can be assessed using the Inner Strength Scale (ISS). Exploring attributes of weaker inner strength may yield valuable information about areas to focus on in enhancing a person's inner strength and may ultimately lead to the perception of better health. Design: Cross-sectional questionnaire survey. Methods: The study is based on responses from 1270 community-dwelling older women aged 65 years and older; these were collected in the year 2010 and describe the situation that still exists today for older women. The questionnaire included the ISS, background characteristics and explanatory variables known to be health threats in ageing. Data were analysed using descriptive and inferential statistics. Results: Poorer mental health was related to weaker inner strength in total and in all the dimensions. Symptoms of depressive disorders and feeling lonely were related to three of the dimensions, except firmness and creativity respectively. Furthermore, poor physical health was associated with the dimensions firmness and flexibility. Other health threats were significantly related to only one of the dimensions, or not associated at all. Conclusion: Mental ill health has overall the strongest association with weaker inner strength. Longitudinal studies are recommended to confirm the results. However, the ISS does not only estimate inner strength but can also be a tool for discovering where (i.e. dimension) interventions may be most profitable.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
connectedness, creativity, firmness, flexibility, health threats, inner strength, mental ill health, nursing, old age, women
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-143949 (URN)10.1111/jan.13341 (DOI)000418363000023 ()28513995 (PubMedID)2-s2.0-85020430693 (Scopus ID)
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2023-03-24Bibliographically approved
Graneheim, U. H., Lindgren, B.-M. & Lundman, B. (2017). Methodological challenges in qualitative content analysis: A discussion paper. Nurse Education Today, 56, 29-34
Open this publication in new window or tab >>Methodological challenges in qualitative content analysis: A discussion paper
2017 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 56, p. 29-34Article in journal (Refereed) Published
Abstract [en]

This discussion paper is aimed to map content analysis in the qualitative paradigm and explore common methodological challenges. We discuss phenomenological descriptions of manifest content and hermeneutical interpretations of latent content. We demonstrate inductive, deductive, and abductive approaches to qualitative content analysis, and elaborate on the level of abstraction and degree of interpretation used in constructing categories, descriptive themes, and themes of meaning. With increased abstraction and interpretation comes an increased challenge to demonstrate the credibility and authenticity of the analysis. A key issue is to show the logic in how categories and themes are abstracted, interpreted, and connected to the aim and to each other. Qualitative content analysis is an autonomous method and can be used at varying levels of abstraction and interpretation.

Place, publisher, year, edition, pages
CHURCHILL LIVINGSTONE, 2017
Keywords
Abstraction level, Categories, Interpretation degree, Latent content, Manifest content, Qualitative content analysis, Themes
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-138630 (URN)10.1016/j.nedt.2017.06.002 (DOI)000406725700006 ()28651100 (PubMedID)2-s2.0-85021166616 (Scopus ID)
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2024-04-11Bibliographically approved
Norberg, A., Ternestedt, B.-M. & Lundman, B. (2017). Moments of homecoming among people with advanced dementia disease in a residential care facility. Dementia, 16(5), 629-641
Open this publication in new window or tab >>Moments of homecoming among people with advanced dementia disease in a residential care facility
2017 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 16, no 5, p. 629-641Article in journal (Refereed) Published
Abstract [en]

This study concerns moments of homecoming among people with advanced dementia disease living in a residential care facility. Our main finding from participant observations with nine residents was that the residents showed moments of homecoming, i.e. they alternated between verbal and/or nonverbal expressions of feeling at home and of not feeling at home. If care providers understand that they can help people with advanced dementia disease experience moments of homecoming, they can focus on aspects of care that can promote these experiences.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
dementia, ethnography, feeling at home, homecoming, residential care
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-114784 (URN)10.1177/1471301215613699 (DOI)000405005100006 ()26507520 (PubMedID)2-s2.0-85022080995 (Scopus ID)
Available from: 2016-02-01 Created: 2016-01-28 Last updated: 2023-03-24Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-2929-9248

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