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Continuity means "preserving a consistent whole" - A grounded theory study.
Göteborgs Universitet.ORCID iD: 0000-0002-7633-482X
Göteborgs Universitet.
Göteborgs Universitet.
2015 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 29872Article in journal (Refereed) Published
Abstract [en]

Living with a chronic disease like chronic heart failure (CHF) results in disruptions, losses, and setbacks in the participants' daily lives that affect health and well-being. By using grounded theory method, we illuminate whether persons with CHF experience discontinuity in life and, if so, what helps them to preserve and strengthen continuity in their daily lives. Thirteen individual interviews and one group interview with five participants, aged 62 to 88 years, were carried out. Through data collection and data analysis, we constructed three concepts that make up a model illustrating the participants' experiences in daily life in relation to corporeality, temporality, and identity: experiences of discontinuity, recapturing approaches, and reconciliation. The first concept, experiences of discontinuity, was constructed from the following categories: the alienated body, the disrupted time, and the threatened self. The second concept, recapturing approaches, consists of categories with continuity creative constructions: repossessing the body, maintaining a façade, seizing the day, restoring the balance of time, and preserving self. These actions are intended to overcome problems and master changes in order to maintain balance in daily life through constructions that recreate normality and predictability. The third concept, reconciliation, was constructed from three categories: feel normal, set to adjust, and be positioned. These categories describe how the participants minimize their experiences of discontinuity by recapturing approaches in order to reconcile with various changes and maintain continuity in daily life. Our findings provide a fresh perspective on continuity that may contribute to the development of significant interventions in continuity of care for persons with CHF. However, continuity requires that healthcare systems support each patient's ability to manage change, reorientation, and adjustment to the new situation in order to make it easier for the patient to create and continue living their daily lives as they desire.

Place, publisher, year, edition, pages
2015. Vol. 10, article id 29872
Keywords [en]
Chronic disease, continuity, grounded theory method, heart failure, life expectations
National Category
Nursing
Identifiers
URN: urn:nbn:se:hb:diva-12749DOI: 10.3402/qhw.v10.29872ISI: 000367312100001PubMedID: 26714652Scopus ID: 2-s2.0-84961842274OAI: oai:DiVA.org:hb-12749DiVA, id: diva2:1144925
Available from: 2017-09-27 Created: 2017-09-27 Last updated: 2020-12-03Bibliographically approved
In thesis
1.
The record could not be found. The reason may be that the record is no longer available or you may have typed in a wrong id in the address field.
2. Kontinuitet som grund för vårdande och hälsa vid hjärtsvikt: patienters, närståendes och sjuksköterskors perspektiv
Open this publication in new window or tab >>Kontinuitet som grund för vårdande och hälsa vid hjärtsvikt: patienters, närståendes och sjuksköterskors perspektiv
2020 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim was to examine continuity of care for persons with heart failure from the patients’, next of kin’s and nurses’ perspectives.

Methods: This thesis has a caring science approach and consists of four qualitative studies conducted in a health care context. Studies I and II are based on patients’ experiences of continuity in heart failure. The data were collected through individual interviews and a group interview that was analysed using the grounded theory method. Study III is based on next of kin’s perceptions of continuity of care in heart failure. The data were collected with individual interviews and analysed using a phenomenographic method. Study IV is based on nurses’ perceptions of continuity of care for patients with heart failure. The data were collected with focus group interviews and analysed using a phenomenographic method.

Results: Continuity of care supports caring and health. To patients, continuity is what connects care and life. Continuity of care creates conditions that support the patient’s health processes and vitality; it contributes to the patient being able to maintain continuity in life. To the next of kin, continuity of care contributes to a feeling of being in “good hands”. Continuity can be the support that next of kin need to integrate care into their daily life with the patient and to find a balance between responsibility and commitment in the patient’s care. Nurses have a unique opportunity to create continuity of care in a way that meets the needs and conditions of both patients and next of kin. When continuity is created based on patients’ needs, in a way that is meaningful and relevant to patients’ health, continuity contributes to well-being, safety and autonomy for patients and next of kin. Continuity of care also makes it easier for nurses to collaborate with the patients, next of kin and other professionals.

Conclusion: Continuity makes care caring. Continuity of care supports patients and next of kin to manage life adaptation that accompanies the disease and preserve their well-being and health as much as possible. Continuity of care supports nurses’ professional practice.

Place, publisher, year, edition, pages
Borås: Högskolan i Borås, 2020
Series
Skrifter från Högskolan i Borås, ISSN 0280-381X ; 108
Keywords
Caring, Continuity, Continuity of care, Focus groups, Grounded theory, Heart failure, Next of kin, Nurses, Patients, Phenomenography, Qualitative interviews
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-23394 (URN)978-91-88838-78-0 (ISBN)978-91-88838-79-7 (ISBN)
Public defence
2020-10-09, M404, Allégatan 1, Borås, 11:00 (Swedish)
Opponent
Available from: 2020-12-03 Created: 2020-06-24 Last updated: 2020-12-03Bibliographically approved

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Östman, Malin

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