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Web-based counselling to patients with haematological diseases
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Högskolan i Jönköping, HHJ. ADULT.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Patients with haematological diseases are entitled to supportive care. Considering organisational and technological development, support in the form of caring communication provided through the web is today a possible alternative. The aim of this thesis was to examine the usefulness and importance of a web-based counselling service to patients with haematological diseases. The basis for the thesis was a development project funded by the Swedish Cancer Society, which provided an opportunity to offer patients communication with a nurse through a web-based counselling service.

Four studies were performed from a patient perspective. Study I had a cross-sectional design, measuring occurrence of anxiety and depression, and these variables’ associations to mastery, social support, and insomnia among patients with haematological diseases. Study II was a qualitative content analysis focusing on conditions for provision and use of the web-based counselling service. Study III used a qualitative hermeneutical approach to focus on patients’ experiences of using the counselling service. Study IV was a qualitative deductive analysis examining how communication within the web-based counselling service can be caring in accordance to caring theory.

The results revealed that females of 30-49 years of age are vulnerable to experiencing anxiety. Low sense of mastery and support are associated with anxiety and/or depression. Being able to self-identify the need for support as well as appreciate the written medium are necessary conditions for the web-based counselling service to be used. The counselling service must also be part of a comprehensive range of supportive activities and web-based services to be useful. The main importance of the communication is that the patient’s influence on the communication is strengthened, and that the constant access to individual medical and caring assessment can imply a sense of safety. When patients share their innermost concerns and search for support, nursing compassion and competence can substantiate in explicit written responses.

A conclusion is that there is a caring potential in communication within a web-based counselling service. To make this form of communication possible, nurses should take possession of and ensure that this medium for communication is offered to patients. Nurses should also increase their knowledge of caring communication in writing and how this possibly can impact patients.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, Jönköping University , 2015. , p. 85
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 57
Keywords [en]
haematological disease, web-based counselling, caring communication
National Category
Nursing
Research subject
Människan i vården
Identifiers
URN: urn:nbn:se:hb:diva-119ISBN: 978-91-85835-56-0 (print)OAI: oai:DiVA.org:hb-119DiVA, id: diva2:814327
Public defence
2015-05-29, Sparbankssalen, Borås, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-05-29 Created: 2015-05-26 Last updated: 2016-01-21Bibliographically approved
List of papers
1. Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care
Open this publication in new window or tab >>Prerequisites required for the provision and use of web-based communication for psychosocial support in haematologic care
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2013 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 5, p. 596-602Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this study was to describe the prerequisites required for the provision and use of web-based communication for psychosocial support within a haematology clinic, from a patient and family perspective. Method: A qualitative design using content analysis was used. A strategically selected sample of patients ( n ¼ 11) and family members ( n ¼ 6) were offered access to a web-based communication capability with a nurse. After four months, individual interviews were conducted with all participants, in order to identify necessary prerequisites. Results: Preferences and characteristics of the individual patient or family member are crucial as to whether web-based communication for support is perceived as useful. To feel comfortable with writing and to self-identify the need for support are fundamental in getting motivated to use web-based com- munication. An effective organization around psychosocial support in general is another prerequisite. Goals and responsibilities must be clearly de fi ned for patients and family members to understand their rights and enable the transformation of opportunities into practice. The use of web-based communi- cation must also be a convenient and naturally incorporated part of both individual and organizational use of the web in general. Conclusions: Prerequisites of taking into account caretakers ’ different preferences and needs, providing highly structured psychosocial support activities and providing a congruent range of web services, are necessary for successful provision and use of web-based communication for psychosocial support.

Place, publisher, year, edition, pages
Elsevier Sci LTD, 2013
Keywords
Needs, Health, Communication, Cancer, Supportive care, Haematology, Cancervård
National Category
Nursing
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-1642 (URN)10.1016/j.ejon.2013.01.005 (DOI)000325600800012 ()23453568 (PubMedID)2320/12862 (Local ID)2320/12862 (Archive number)2320/12862 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-10-24Bibliographically approved
2. The meaning of web-based support: from the patients' perspective within a hematological healthcare setting.
Open this publication in new window or tab >>The meaning of web-based support: from the patients' perspective within a hematological healthcare setting.
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2015 (English)In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 38, no 2, p. 145-154Article in journal (Refereed) Published
Abstract [en]

Background: Being critically ill with a hematological disease is a challenge, sometimes causing a need for support in the adjustment to the stressful life situation. By providing Web-based communication for support from a nurse, patients get access to an alternative and untraditional way to communicate their issues. Objective: The aim was to describe the meaning of using Web-based communication for support from a patient perspective. Methods: A comprehensive randomized pilot study (n = 30) was conducted, allowing 15 patients in the experimental group to have access to the Web-based communication, to evaluate feasibility. Of these 15 participants, 10 were interviewed, focusing on their experiences. An empirical hermeneutical approach was used and the interpretive analysis focused on the meanings. Results: Web-based communication for support means a space for patients to have their say, consolidation of a matter, an extended caring relationship, access to individual medical assessment, and an opportunity for emotional processing. The main interpretation indicates that the patient's influence on the communication strengthens according to the asynchronous, faceless, and written communication. The increased, and in some sense constant, access to an individual medical and caring assessment, in turn, implies a feeling of safety. Conclusion: Web-based communication for support seems to have the potential to enhance patients' participation on their own terms. Implications for Practice: To achieve the possible advantages of Web-based communication for support, nurses must acquire knowledge about caring writing. It requires respect for the patient and articulated accuracy and attention in the response given.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2015
National Category
Nursing
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2034 (URN)10.1097/NCC.0000000000000145 (DOI)000349907900015 ()24831039 (PubMedID)2-s2.0-84924294884 (Scopus ID)2320/14635 (Local ID)2320/14635 (Archive number)2320/14635 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2018-12-07Bibliographically approved

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