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Lundell, S., Isaksson, U., Coe, A.-B., Harrison, S. L. & Hajdarevic, S. (2024). Swedish translation and psychometric testing of the self-conscious emotions in COPD questionnaire. Respiratory Medicine, 226, Article ID 107624.
Open this publication in new window or tab >>Swedish translation and psychometric testing of the self-conscious emotions in COPD questionnaire
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2024 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 226, article id 107624Article in journal (Refereed) Published
Abstract [en]

Assessment of self-conscious emotions is important to develop tailored interventions for people with chronic obstructive pulmonary disease (COPD). Previous instruments have largely been developed for mental health populations. The Self-Conscious Emotions in COPD Questionnaire was the first instrument to assess self-conscious emotions in people with COPD, but it was only available in English.

The aim was to translate the Self-Conscious Emotions in COPD Questionnaire into Swedish and to evaluate its psychometric properties and internal structure in a Swedish context.

The translation process included forward and backward translation, a multidisciplinary meeting, assessment of content validity, and cognitive interviews. The translated instrument was tested in a sample of 173 people with COPD between September 2021 and September 2022. Parallel analysis (PA), exploratory factor analysis (EFA), and test-retest reliability was performed.

The content validity index (CVI) for the instrument was 0.88. Based on the PA, an EFA with a two-factor solution was conducted, with a high Cronbach's alpha (0.786-0.821), and one item about self-blame was excluded. The two factors were labelled: The burden of living with a disability and The desire to hide vulnerability. Test-retest reliability showed no difference between scale scores on factor or item level, except for one item.

The Swedish Self-Conscious Emotions in COPD showed good validity and reliability. One item was excluded from the two subscales, indicating that the instrument needs to be further developed to cover the concept of self-blame. The instrument is expected to be a valuable tool for assessing self-conscious emotions in people with COPD.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Chronic obstructive pulmonary disease, Emotions, Psychometry, Reliability, Self-consciousness, Validity.
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-223353 (URN)10.1016/j.rmed.2024.107624 (DOI)2-s2.0-85189985496 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2020-01129
Available from: 2024-04-15 Created: 2024-04-15 Last updated: 2024-04-23Bibliographically approved
Nyberg, A., Sondell, A., Lundell, S., Marklund, S., Tistad, M. & Wadell, K. (2023). Experiences of using an electronic health tool among health care professionals involved in chronic obstructive pulmonary disease management: qualitative analysis. JMIR Human Factors, 10, Article ID e43269.
Open this publication in new window or tab >>Experiences of using an electronic health tool among health care professionals involved in chronic obstructive pulmonary disease management: qualitative analysis
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2023 (English)In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 10, article id e43269Article in journal (Refereed) Published
Abstract [en]

Background: Chronic obstructive pulmonary disease (COPD) is one of the most common and deadliest chronic diseases of the 21st century. eHealth tools are seen as a promising way of supporting health care professionals in providing evidence-based COPD care, for example, by reinforcing information and interventions provided to the patients and providing easier access and support to the health care professional themselves. Still, knowledge is scarce on the experience of using eHealth tools from the perspective of the health care professional involved in COPD management.

Objective: The study explored the experiences of using an eHealth tool among health care professionals that worked with patients with COPD in their daily clinical practice.

Methods: This exploratory qualitative study is part of a process evaluation in a parallel group, controlled, pragmatic pilot trial. Semistructured interviews were performed with 10 health care professionals 3 and 12 months after getting access to an eHealth tool, the COPD Web. The COPD Web, developed using cocreation, is an interactive web-based platform that aims to help health care professionals provide health-promoting strategies. Data from the interviews were analyzed using qualitative content analysis with an inductive approach.

Results: The main results reflected health care professionals’ experiences in 3 categories: receiving competence support and adjusting practice, improving quality of care, and efforts required for implementation. These categories highlighted that using an eHealth tool such as the COPD Web was experienced to provide knowledge support for health care professionals that led to adaptation and facilitation of working procedures and person-centered care. Taken together, these changes were perceived to improve the quality of care through enhanced patient contact and encouragement of interprofessional collaboration. In addition, health care professionals expressed that patients using the COPD Web were better equipped to tackle their disease and adhered better to provided treatment, increasing their self-management ability. However, structural and external barriers bar the successful implementation of an eHealth tool in daily praxis.

Conclusions: This study is among the first to explore experiences of using an eHealth tool among health care professionals involved in COPD management. Our novel findings highlight that using an eHealth tool such as the COPD Web may improve the quality of care for patients with COPD (eg, by providing knowledge support for health care professionals and adapting and facilitating working procedures). Our results also indicate that an eHealth tool fosters collaborative interactions between patients and health care professionals, which explains why eHealth is a valuable means of encouraging well-informed and autonomous patients. However, structural and external barriers requiring time, support, and education must be addressed to ensure that an eHealth tool can be successfully implemented in daily praxis.

Place, publisher, year, edition, pages
JMIR Publications Inc., 2023
Keywords
care, chronic, clinical, COPD, eHealth, electronic, health care professionals, implementation, internet, management, primary care, pulmonary, support, tools, web based
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Physiotherapy
Identifiers
urn:nbn:se:umu:diva-206748 (URN)10.2196/43269 (DOI)36995743 (PubMedID)2-s2.0-85151911915 (Scopus ID)
Available from: 2023-05-03 Created: 2023-05-03 Last updated: 2024-03-22Bibliographically approved
Nyberg, A., Lundell, S., Stenlund, T., Marklund, S. & Wadell, K. (2023). KOLwebben ökar kunskapen hos både personer med KOL och personal. Fysioterapi (1), 30-35
Open this publication in new window or tab >>KOLwebben ökar kunskapen hos både personer med KOL och personal
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2023 (Swedish)In: Fysioterapi, ISSN 1653-5804, no 1, p. 30-35Article, review/survey (Other (popular science, discussion, etc.)) Published
Abstract [sv]

I ett försök att minska gapet mellan rådande riktlinjer gällande icke-farmakologiska interventioner och den vård som erbjuds till personer med KOL har vi, tillsammans med användare, utvecklat och utvärderat KOLwebben. Användning av KOLwebben ledde till en kliniskt relevant ökad fysisk aktivitetsnivå och en ökad kunskap om egenvårdsstrategier hos personer med KOL. Hälso- och sjukvårdspersonal i regional primärvård och kommunal hemsjukvård rapporterade ökad kunskap om sjukdomen, behandlingsmetoder, arbetssätt och att verktyget är ett stöd i deras arbete. Initialt krävs dock extra resurser i form av tid och rutiner för att implementering ska ske. Ett digitalt stöd som KOLwebben kan rekommenderas till personer som är motiverade till att använda e-hälsoverktyg och som har en tillräcklig förmåga att ta till sig information om sin hälsa.

Place, publisher, year, edition, pages
Fysioterapeuterna, 2023
Keywords
COPD, e-health, chronic obstructive pulmonary disease, KOL, e-hälsa, kroniskt obstruktiv lungsjukdom
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-222316 (URN)
Available from: 2024-03-13 Created: 2024-03-13 Last updated: 2024-03-22Bibliographically approved
Pettersson, B., Lundell, S., Lundin-Olsson, L. & Sandlund, M. (2023). 'Maintaining balance in life'—exploring older adults' long-term engagement in self-managed digital fall prevention exercise. European Review of Aging and Physical Activity, 20(1), Article ID 12.
Open this publication in new window or tab >>'Maintaining balance in life'—exploring older adults' long-term engagement in self-managed digital fall prevention exercise
2023 (English)In: European Review of Aging and Physical Activity, ISSN 1813-7253, E-ISSN 1861-6909, Vol. 20, no 1, article id 12Article in journal (Refereed) Published
Abstract [en]

Background: Accidental falls are one of the greatest threats to older adults’ health and well-being. The risk of falling can be significantly reduced with strength and balance interventions. However, there needs to be further knowledge into how older adults can be supported to achieve a maintained exercise behaviour. Therefore, the aim of this study was to explore factors that enabled older adults to maintain their exercise during a 1-year self-managed digital fall prevention exercise intervention.

Methods: This study used a grounded theory methodology. Semi-structured individual interviews were conducted by phone or conference call. Eighteen community-dwelling older adults aged 70 years or more participated. The participants had a self-reported exercise dose of 60 min or more per week during the last three months of participation in a 12-months intervention of self-managed digital fall prevention exercise, the Safe Step randomized controlled trial. Open, axial, and selective coding, along with constant comparative analysis, was used to analyze the data.

Results: The analysis resulted in a theoretical model. We found that the fall prevention exercise habits of adults were developed through three stages: Acting against threats to one’s own identity, Coordinating strategies to establish a routine, and Forming habits through cues and evaluation. The main category of Maintaining balance in life encases the participants transition through the three stages and reflects balance in both physical aspects and in between activities in daily life. The process of maintaining balance in life and desire to do so were mediated both by intrinsic person-dependent factors and the Safe Step application acting as an external mediator.

Conclusion: This study identified three stages of how older adults developed self-managed fall prevention exercise habits, supported by a digital application. The generated theoretical model can inform future interventions aiming to support long-term engagement in digitally supported and self-managed fall prevention interventions.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Aged, Behaviour change, eHealth, Exercise, Fall prevention, Grounded Theory, Habit formation, mHealth, Older adults, Self-management
National Category
Physiotherapy Geriatrics
Identifiers
urn:nbn:se:umu:diva-212503 (URN)10.1186/s11556-023-00322-7 (DOI)37464299 (PubMedID)2-s2.0-85165253094 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2020–00589
Available from: 2023-08-01 Created: 2023-08-01 Last updated: 2023-08-01Bibliographically approved
Sönnerfors, P., Skavberg Roaldsen, K., Lundell, S., Toots, A., Wadell, K. & Halvarsson, A. (2023). Preferences for an eHealth tool to support physical activity and exercise training in COPD: a qualitative study from the viewpoint of prospective users. BMC Pulmonary Medicine, 23(1), Article ID 65.
Open this publication in new window or tab >>Preferences for an eHealth tool to support physical activity and exercise training in COPD: a qualitative study from the viewpoint of prospective users
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2023 (English)In: BMC Pulmonary Medicine, E-ISSN 1471-2466, Vol. 23, no 1, article id 65Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Despite well-known positive effects of pulmonary rehabilitation, access is limited. New strategies to improve access are advocated, including the use of eHealth tools.

OBJECTIVES: The aim of this study was to explore prospective users' preferences for an eHealth tool to support the self-management of physical activity and exercise training in COPD.

METHODS: A qualitative research design was applied. Data was collected in six, audio recorded, digital co-creation workshops, which were guided by a participatory and appreciative action and reflection approach. A total of 17 prospective users took part in the process, including people with COPD (n = 10), relatives (n = 2), health care givers (n = 4) and a patient organization representative (n = 1). During the workshops, pre-selected relevant topics to exploring end-users' preferences for eHealth support in self-management in COPD were discussed. The workshops were recorded and transcribed. Data was analysed using inductive qualitative content analysis.

RESULTS: The overarching theme "fusing with, rather than replacing existing support structures" was uncovered when the two-sided relationship between positive expectations towards digital solutions and the fear of losing access to established rehabilitation systems, emerged in the discussions. Three categories were identified, focused on wishes for an evidence-based support platform of information about COPD, a well-designed eHealth tool including functionalities to motivate in the self-management of physical activity and exercise training, and requirements of various forms of support. Co-creators believed that there were clear benefits in combining the best of digital and existing support systems.

CONCLUSIONS: Co-creators viewed an eHealth tool including support for physical activity and exercise training as a valuable digital complement to the now existing rehabilitation services. A future eHealth tool needs to focus on user-friendliness and prospective users's requests.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Communication, Health literacy, Internet use, Telemedicine, Telerehabilitation
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-205129 (URN)10.1186/s12890-023-02353-3 (DOI)000932073000001 ()36782155 (PubMedID)2-s2.0-85147958142 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20190406Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2023-02-23 Created: 2023-02-23 Last updated: 2024-01-17Bibliographically approved
Nyberg, A., Lundell, S., Pesola, U.-M., Audulv, Å. & Wadell, K. (2022). Evaluation of a Digital COPD Education Program for Healthcare Professionals in Long-Term Care: A Mixed Methods Study. The International Journal of Chronic Obstructive Pulmonary Disease, 17, 905-918
Open this publication in new window or tab >>Evaluation of a Digital COPD Education Program for Healthcare Professionals in Long-Term Care: A Mixed Methods Study
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2022 (English)In: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 17, p. 905-918Article in journal (Refereed) Published
Abstract [en]

Background: Lack of routines and competence among healthcare professionals have been reported as barriers to COPD management in long-term care. Online education could be used as a strategy to make COPD education more accessible.

Purpose: The aim of this study was to evaluate a digital COPD education program for healthcare professionals in long-term care regarding feasibility, knowledge and working procedures.

Methods: A randomized controlled feasibility trial with a convergent mixed methods design was conducted. Two municipalities in Sweden were randomized to intervention (n=20) or control (n=17). The intervention was a digital COPD education program accessible for three months. Data was collected through questionnaires on COPD-specific knowledge, conceptual knowledge, feasibility and usage of the COPD Web platform. Repeated individual interviews using a semi-structured interview guide was also performed. Quantitative and qualitative findings were merged using a mixed methods design.

Results: The digital COPD education program appears feasible based on the expressed satisfaction of the healthcare workers and their reports that it supported them in their work. Across questionnaires, objective COPD-specific knowledge increased by 14 to 16 percentage points in the intervention group compared to 0 to 6 percentage points in the control group (p=0.001). The objective increase in COPD-specific knowledge was also captured in the interviews, where a perceived increase in knowledge led to increased security and focus on COPD management. Few changes in working procedures were expressed, but participants felt that attention was raised regarding COPD and the importance of preventive healthcare services. In addition, increased knowledge of healthcare services provided by other involved professions was emphasized, leading to discussions with other professions in relation to COPD management. 

Conclusion: A digital COPD education program is feasible and can increase the COPD-specific knowledge of healthcare professionals in long-term care, leading to increased focus on COPD-related issues. More comprehensive measures, including organizational changes, might be needed to change working procedures.

Place, publisher, year, edition, pages
Dove press, 2022
Keywords
e-health, feasibility, work task, qualitative longitudinal research, questionnaire
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-194111 (URN)10.2147/copd.s353187 (DOI)000791768200005 ()35497374 (PubMedID)2-s2.0-85129780793 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20160505Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Note

The abstract of this paper was presented at the European Respiratory Society Annual Conference 2021 as a poster presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in European Respiratory Journal 2021 58: PA758; DOI: 10.1183/13993003.congress-2021.PA758.

Available from: 2022-04-25 Created: 2022-04-25 Last updated: 2024-03-22Bibliographically approved
Lundell, S., Toots, A., Sönnerfors, P., Halvarsson, A. & Wadell, K. (2022). Participatory methods in a digital setting: experiences from the co-creation of an eHealth tool for people with chronic obstructive pulmonary disease. BMC Medical Informatics and Decision Making, 22(1), Article ID 68.
Open this publication in new window or tab >>Participatory methods in a digital setting: experiences from the co-creation of an eHealth tool for people with chronic obstructive pulmonary disease
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2022 (English)In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 22, no 1, article id 68Article in journal (Refereed) Published
Abstract [en]

Background: Using participatory methods to engage end-users in the development and design of eHealth is important to understand and incorporate their needs and context. Within participatory research, recent social distancing practice has forced a transition to digital communication platforms, a setting that warrants deeper understanding. The aim of this study was to describe the experiences of, and evaluate a digital co-creation process for developing an eHealth tool for people with chronic obstructive pulmonary disease (COPD).

Methods: The co-creation was guided by Participatory appreciative action and reflection, where a convenience sample (n = 17), including persons with COPD, health care professionals, relatives and a patient organization representative participated in six digital workshops. User instructions, technical equipment, and skilled support were provided if necessary. Workshops centred around different topics, with pre-recorded films, digital lectures and home assignments to up-skill participants. Process validity, experiences and ownership in the co-creation process were evaluated by repeated respondent validation, member checking, questionnaires and by assessing attendance. Data was analysed quantitatively or qualitatively as appropriate.

Results: The co-creators were in general satisfied with the digital format of the workshops. Mean attendance and perceived engagement in workshops was high and the experience described as enjoyable. Engagement was facilitated by up-skilling activities and discussions in small groups. Few had used digital communication previously, and feelings ranging from excitement to concern were expressed initially. Technical issues, mainly audio related, were resolved with support. At completion, skills using equipment and digital platform surpassed expectations. Few disadvantages with the digital format were identified, and advantages included reduced travel, time efficiency and reduced infection risk.

Conclusions: Experiences of digital co-creation were overwhelmingly positive, despite initial barriers related to computer naivety and use of digital equipment and platforms. The high level of satisfaction, engagement, attendance rates, and agreement between individual and group views suggests that a digital co-creation process is a feasible method. Several important success factors were identified, such as the provision of information and education on discussion topics in advance of workshops, as well as the smaller group discussions during workshops. The knowledge gained herein will be useful for future digital co-creation processes.

Place, publisher, year, edition, pages
BioMed Central, 2022
Keywords
COPD, Personalised medicine, Telemedicine, User involvement, Video conference
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-193409 (URN)10.1186/s12911-022-01806-9 (DOI)000770622500002 ()35303895 (PubMedID)2-s2.0-85126645586 (Scopus ID)
Funder
Swedish Heart Lung Foundation, 20190406Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2022-03-31 Created: 2022-03-31 Last updated: 2022-05-10Bibliographically approved
Marklund, S., Tistad, M., Lundell, S., Östrand, L., Sörlin, A., Boström, C., . . . Nyberg, A. (2021). Experiences and factors affecting usage of an ehealth tool for self-management among people with chronic obstructive pulmonary disease: qualitative study. Journal of Medical Internet Research, 23(4), Article ID e25672.
Open this publication in new window or tab >>Experiences and factors affecting usage of an ehealth tool for self-management among people with chronic obstructive pulmonary disease: qualitative study
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2021 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 23, no 4, article id e25672Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Self-management strategies are regarded as highly prioritized in chronic obstructive pulmonary disease (COPD) treatment guidelines. However, individual and structural barriers lead to a staggering amount of people with COPD that are not offered support for such strategies, and new approaches are urgently needed to circumvent these barriers. A promising way of delivering health services such as support for self-management strategies is the use of eHealth tools. However, there is a lack of knowledge about the usage of, and factors affecting the use of, eHealth tools over time in people with COPD.

OBJECTIVE: This study aimed, among people with COPD, to explore and describe the experiences of an eHealth tool over time and factors that might affect usage.

METHODS: The eHealth tool included information on evidence-based self-management treatment for people with COPD, including texts, pictures, videos as well as interactive components such as a step registration function with automatized feedback. In addition to the latter, automated notifications of new content and pedometers were used as triggers to increase usage. After having access to the tool for 3 months, 16 individuals (12 women) with COPD were individually interviewed. At 12 months' access to the tool, 7 (5 women) of the previous 16 individuals accepted a second individual interview. Data were analyzed using qualitative content analysis. User frequency was considered in the analysis, and participants were divided into users and nonusers/seldom users depending on the number of logins and minutes of usage per month.

RESULTS: Three main categories, namely, ambiguous impact, basic conditions for usage, and approaching capability emerged from the analysis, which, together with their subcategories, reflect the participants' experiences of using the eHealth tool. Nonusers/seldom users (median 1.5 logins and 1.78 minutes spent on the site per month) reported low motivation, a higher need for technical support, a negative view about the disease and self-management, and had problematic health literacy as measured by the Communicative and Critical Health Literacy Scale (median [range] 154 [5-2102]). Users (median 10 logins and 43 minutes per month) felt comfortable with information technology (IT) tools, had a positive view on triggers, and had sufficient health literacy (median [range] 5 [5-1400]). Benefits including behavior changes were mainly expressed after 12 months had passed and mainly among users.

CONCLUSIONS: Findings of this study indicate that the level of motivation, comfortability with IT tools, and the level of health literacy seem to affect usage of an eHealth tool over time. Besides, regarding behavioral changes, gaining benefits from the eHealth tool seems reserved for the users and specifically after 12 months, thus suggesting that eHealth tools can be suitable media for supporting COPD-specific self-management skills, although not for everyone or at all times. These novel findings are of importance when designing new eHealth tools as well as when deciding on whether or not an eHealth tool might be appropriate to use if the goal is to support self-management among people with COPD.

Place, publisher, year, edition, pages
Toronto: JMIR Publications, 2021
Keywords
COPD, chronic disease, eHealth, primary care, qualitative content analysis, self-management
National Category
Physiotherapy
Research subject
physiotherapy
Identifiers
urn:nbn:se:umu:diva-183265 (URN)10.2196/25672 (DOI)000646934500004 ()33929327 (PubMedID)2-s2.0-85105370296 (Scopus ID)
Funder
Swedish Research Council, K2014-99X-22572-01-4Swedish Heart Lung Foundation, 20130331
Note

Trial Registration: ClinicalTrials.gov NCT02696187; https://clinicaltrials.gov/ct2/show/NCT02696187

International Registered Report Identifier: RR2-10.1136/bmjopen-2017-016851

Available from: 2021-05-20 Created: 2021-05-20 Last updated: 2024-03-22Bibliographically approved
Lundell, S., Pesola, U.-M., Nyberg, A. & Wadell, K. (2020). Conditions for COPD management in municipal healthcare: healthcare professionals' perspective. A qualitative study. European Respiratory Journal, 56
Open this publication in new window or tab >>Conditions for COPD management in municipal healthcare: healthcare professionals' perspective. A qualitative study
2020 (English)In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
European Respiratory Society, 2020
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-180162 (URN)10.1183/13993003.congress-2020.78 (DOI)000606501400014 ()
Note

Supplement: 64

Meeting Abstract: 78

Available from: 2021-02-18 Created: 2021-02-18 Last updated: 2024-03-22Bibliographically approved
Lundell, S., Wadell, K., Wiklund, M. & Tistad, M. (2020). Enhancing confidence or coping with stigma in an ambiguous interaction with primary care: a qualitative study of people with COPD. COPD: Journal of Chronic Obstructive Pulmonary Disease, 17(5), 533-542
Open this publication in new window or tab >>Enhancing confidence or coping with stigma in an ambiguous interaction with primary care: a qualitative study of people with COPD
2020 (English)In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563, Vol. 17, no 5, p. 533-542Article in journal (Refereed) Published
Abstract [en]

Meaningful and high-quality interactions between people with COPD and healthcare professionals are essential to accomplish effective and efficient self-management. This study's aim was to explore how people with COPD experience COPD-related interactions with healthcare professionals in primary care, and how these interactions influence their self-management and how they cope with their disease. Interviews were performed with eight women and five men with COPD, and grounded theory guided data collection and analysis. The analysis resulted in a theoretical model and the core category (Re)acting in an ambiguous interaction, representing a dynamic process in which healthcare priorities, healthcare professionals' attitudes and participants' personal emotions were important for the participants' experiences of interactions, and how they managed and coped with their disease. Mutually respectful and regular relationships with healthcare professionals, along with a personal positive view of life, empowered and facilitated participants to accept and manage their disease. In contrast, experiences of being deprioritized and not taken seriously, along with experiences of fear and stigma, disempowered and inhibited participants in making healthcare contacts or forced them to compensate for experienced insufficiencies in primary care. In order to facilitate meaningful and high-quality interactions and enhance patient-provider partnerships in primary care, there is a need to improve the status of COPD, as well as to increase competence in COPD management among healthcare professionals and support the empowerment of people with COPD. Findings from this study could guide the implementation of improved self-management support in primary care for COPD and other chronic conditions.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
empowerment, self-management, healthcare professionals, grounded theory, ambiguity, chronic disease, encounters
National Category
Physiotherapy Respiratory Medicine and Allergy
Research subject
Physiotherapy; Lung Medicine
Identifiers
urn:nbn:se:umu:diva-152608 (URN)10.1080/15412555.2020.1824217 (DOI)000573139100001 ()32981381 (PubMedID)2-s2.0-85091608573 (Scopus ID)
Note

Originally included in thesis in manuscript form.

Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2023-03-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9688-8101

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