Experiences Of Self-care Research Articles

정신건강사회복지사의 자기돌봄에 대한 인식과 경험

정신건강사회복지사의 자기돌봄에 대한 인식과 경험

Needing permission: The experience of self-care and self-compassion in nursing: A constructivist grounded theory study

BackgroundHealthcare is delivered in a culture of ongoing change, with many nurses highlighting the impact of this on their own wellbeing. However, there is a dearth of literature focusing on how nurses care for themselves as they try to provide compassionate care in a challenging job. ObjectivesThis study explored nurses’ experience of self-care and self-compassion and how this may relate to compassionate care giving towards patients. DesignA constructivist grounded theory approach was used to develop a theoretical understanding of nurses’ experience. SettingsThis study included participants from two National Health Service (NHS) Trusts within the United Kingdom (UK). ParticipantsPurposive and theoretical sampling were used to recruit general, mental health and learning disability nurses, at different levels of seniority. MethodBetween September 2015 and March 2016 semi-structured interviews were conducted. Analysis was completed in line with the process set out within constructivist grounded theory. Using constant comparison and memo writing, analysis moved from initial coding to focused coding, through to theoretical coding, resulting in the production of core concepts and categories, and theory development. ResultsThirty participants were included in the study. Three concepts were derived from the data: (1) ‘Hardwired to be caregivers’ – vocation versus role, (2) needing a stable base, (3) Managing the emotions of caring. All three concepts linked to a core process: needing permission to self-care and be self-compassionate. Nurses needed permission from others and from themselves to be self-caring and self-compassionate. An inability to do this affected their wellbeing and compassionate care giving to others. Interviewees described how they struggled particularly with self-compassion. Helping nurses to be proactively more self-caring and self-compassionate may increase their ability to manage emotions and prevent some of the negative consequences of nursing such as burnout and compassion fatigue. A conceptual framework is proposed which identifies that formal permission (e.g., within nursing guidance) may be necessary for some nurses to look after themselves. ConclusionFindings identified the need for permission as key in enabling nurses to self-care and be self-compassionate, which may facilitate them to address patients’ needs. The study highlights the importance of self-care and self-compassion within nursing education and nursing guidance.

Self-care experiences of older patients with diabetes mellitus: A qualitative systematic literature review

Diabetes is a growing health problem and risk increases with age. Self-care is an important part of treatment. The aim of this qualitative systematic literature review was to investigate how older patients with diabetes experience self-care. A systematic literature review relating to older patients, diabetes and self-care was conducted. Systematic searches were carried out in the CINAHL, PubMed/MEDLINE and PsycINFO databases. The results show that older patients with diabetes are mainly concerned with the issues of blood glucose testing, dietary requirements, information about diabetes, motivation and support. To support safe self-care for older patients with diabetes, nurses need opportunities to increase their knowledge and reflection about diabetes and safe self-care support. Further research is needed to identify how nurses can promote older patients’ self-care and quality of life in the context of a person-centred approach.

Postnatal self-care experience of Truku women’s traditions and mainstream acculturation and reconstruction in Taiwan

PurposeThe preservation and disappearance of indigenous people’s traditional knowledge system, under mainstream social culture immersion and fusion, have presented a dynamic and changing acculturation interactive relationship impacting Truku women’s health concepts. Thus, the purpose of this paper is to explore how the traditional Gaya knowledge system and mainstream culture confinement care model affect the beliefs and behaviours of postpartum self-care amongst contemporary Truku women.Design/methodology/approachAn ethnographic semi-structured method, based on cultural care factors and the Leininger Sunrise Model, was conducted to interview 17 Truku women with childbearning experience in eastern Taiwan. As data were collected, UDIST Vivo 11.0 software was applied for analysis.FindingsAmongst the three knowledge system categories, namely, traditional, mainstream and reconstruction, the traditional knowledge system, including Gaya norms, provides the overall cultural value of a Truku family. While taboo is inherited through the experience of the elders, the mainstream knowledge system favours the Han. However, the reconstruction knowledge system highlights the “functional” response strategies based on Truku women’s comfort and conveniences.Originality/valueLimited relevant studies have focused on the health and postpartum self-care knowledge of ethnic Truku women in Taiwan. The results are expected to provide clinical medical personnel with a reference and strengthen cultural sensitivity and the ability to implement the cultural congruency care of postpartum indigenous women in Taiwan.

Student Experience of Self-Care in an Online Master of Science in Nursing Course.

The purpose of this qualitative study was to discover students' experience of self-care in an online master of science in nursing course. The course included caring groups, organized small groups to provide support. The analysis of the personal reflective summaries of 37 students revealed two main themes and five subthemes. Two overarching themes illuminated "Finding Our Inner Selves" and "A Lasting Journey and Not a Destination." The students valued a focus on self-care, goal setting, and support from family, friends, and caring groups. Many mentioned that self-care is an ongoing work in progress.

The Experience of Symptom Cluster and Symptom Alleviation Self-Care in Patients with Head and Neck Cancer: A Qualitative Study

Patients with head and neck cancer usually experience physical and psychological changes and adjustments related to the disease and management of therapy. The patients will experience symptom cluster and will use effective symptom alleviation self-care to relieve the symptoms. The proper identification of symptom cluster and the effectiveness of using symptom alleviation self-care will be the basis for the success of disease management. This study aimed to investigate the symptom cluster and symptom alleviation self-care in patients with head and neck cancer, and which has an impact on the quality of life. This research was a pilot study using a qualitative design and involved five patients at the public hospital in Semarang, Indonesia. The qualitative design has been chosen to explore the varied of symptom experienced by the patients about the nature, number, location, duration and intensity of experiences, which may different experiences of symptom cluster and symptom alleviation self-care for each patient with Head and Neck Cancer. Data were collected through semi-structured interviews and analyzed used the qualitative content analysis process. Three themes were identified in this study, including: the patients’ experience of symptom cluster, the patients’ experience of symptom alleviation self-care, and the impaired quality of life domain. The results of this study showed that the patients’ experience sickness and gastrointestinal symptom cluster during illness and undergoing therapy, as well as variations in the symptom alleviation self-care, including: diet/ nutrition/ lifestyle changes, mind/ body/ spiritual control, biological treatment, herbal treatment, and prescribed medicine. The symptom cluster and symptom alleviation self-care has an impact on the patients’ outcome that is the quality of life. This study showed that the experience of symptom cluster and symptom alleviation self-care varied and highly individualized, which has an impact on the quality of life. The importance of proper identification about symptom cluster and the effectiveness of using symptom alleviation self-care by the nurses will be the basis for the success of disease management to improve the patients’ quality of life. Therefore, optimizing the nurses’ role is needed as the basis for the development of symptom management nursing programs.

Self-Care Management after Ventricular Assist Device Implantation: Recipient Needs and Experiences after Hospital Discharge

Purpose Each year approximately 3,000 individuals with heart failure (HF) receive a ventricular assist device (VAD). Little is known about VAD recipients perceived needs for self-care management and experiences upon discharge from the hospital. The objectives of this study were to explore the perceptions of self-care management needs and challenges experienced as described by VAD recipients in the post-hospital discharge period (ranging from 2 months to 1-year post-implant). Methods In this qualitative descriptive study, one-on-one semi structured interviews were conducted with VAD recipients from an advanced HF program at a Midwestern academic medical center. The interviews focused on perceived needs for self-care management and recipient experiences after discharge from the hospital. The interviews were transcribed verbatim and recurring themes were identified through both independent and collaborative thematic content analysis using three reviewers. Results Twelve VAD recipients completed interviews; eight were male, four were female, all were White/Caucasian, non-Hispanic, and mean age was 56.5 ± 9.6. Half of participants had been implanted 6 months or less from the time of interview. Qualitative content analysis revealed 5 themes: (1) difficulties showering, (2) body image and what to wear, (3) feeling tethered, (4) importance of support system, and (5) lack of comfort with local community health care when living a distance from implant center. Conclusion These findings provide direction in terms of patients perceived needs for a post-discharge self-management intervention. Practical issues (e.g. showering, what to wear, and general VAD maintenance), as well as, broader psychological issues related to dependency on the VAD are a concern for recipients. Importance of the support system including VAD familiarity in local health care providers should be addressed.

Counsellor self-care: Six New Zealand counsellors talk about their self-care practices.

The purpose of this study was to better understand how counsellors in Aotearoa New Zealand experience and practise self-care by inviting six counsellors (three novice and three experienced) to talk about their own self-care experiences and practices, and their reflections concerning counsellor self-care. The study used a mixture of quantitative data from a self-care questionnaire and qualitative data from semi-structured interviews. Major findings were grouped in the following three themes: (1) In spite of some common elements, everyone has a unique way of managing self-care; (2) Self-care is not only what counsellors do, but also what is in their minds, and (3) Self-care is a journey. Self-care changes over time because counsellors learn and grow. [ABSTRACT FROM AUTHOR] Copyright of New Zealand Journal of Counselling is the property of New Zealand Association of Counsellors and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

‘I’ve put diabetes completely on the shelf till the mental stuff is in place’. How patients with doctor-assessed impaired self-care perceive disease, self-care, and support from general practitioners. A qualitative study

Objective: This paper investigated patients’ experiences of disease and self-care as well as perceptions of the general practitioner’s role in supporting patients with impaired self-care ability.Design: Qualitative interviews with 13 patients with type 2 diabetes, concurrent chronic diseases, and impaired self-care ability assessed by a general practitioner. We analyzed our data using systematic text condensation. The shifting perspectives model of chronic illness formed the theoretical background for the study.Results: Although most patients experienced challenges in adhering to recommended self-care activities, many had developed additional, personal self-care routines that increased wellbeing. Some patients were conscious of self-care trade-offs, including patients with concurrent mental disorders who were much more attentive to their mental disorder than their somatic diseases. Patients’ perspectives on diseases could shift over time and were dominated by emotional considerations such as insisting on leading a normal life or struggling with limitations caused by disease. Most patients found support in the ongoing relationship with the same general practitioner, who was valued as a companion or appreciated as a trustworthy health informant.Conclusion: Patient experiences of self-care may collide with what general practitioners find appropriate in a medical regimen. Health professionals should be aware of patients’ prominent and shifting considerations about the emotional aspects of disease. Patients valued the general practitioner’s role in self-care support, primarily through the long-term doctor-patient relationship. Therefore, relational continuity should be prioritized in chronic care, especially for patients with impaired self-care ability who often have a highly complex disease burden and situational context.Key points Little is known about the perspectives of disease and self-care in patients with a doctor-assessed impaired ability of self-care. • Although patients knew the prescribed regimen they often prioritized self-care routines that increased well-being at the cost of medical recommendations. • Shifting emotional aspects were prominent in patients’ considerations of disease and sustained GPs’ use of a patient-centred clinical method when discussing self-care. • Relational continuity with general practitioners was a highly valued support and should be prioritized for patients with impaired self-care.

Perceptions of fluid restriction self-care in heart failure

Objectives: Daily fluid restriction reduces fluid retention and therefore lessens the symptom burden of heart failure but the literature shows that adherence is sub-optimal. The objectives of the current study were to understand patients' experiences of fluid restriction self-care and identify factors affecting adherence. Methods: Semi-structured interviews were conducted with four inpatients. Data were interpreted using the World Health Organization's dimensions affecting adherence; these dimensions were patient-related, condition-related, therapy-related, health system/team-related and socioeconomic-related. Findings: Fluid restriction self-care was unpleasant and challenging. The most commonly reported factors were in the therapy-related dimension, and included unrelenting, uncomfortable thirst and dry mouth, which were a cause of significant distress. Patients reported unease about the complexity of the condition, misunderstood the treatment rationale and were confused about the benefit of adherence. Conclusions: The current study supports the current consensus that self-care for long-term conditions is complex and challenging. More patient-focused research is advised to address difficulties in adhering to fluid restriction. Improvement in thirst and dry-mouth alleviation strategies is needed.

Conceptualisation of home among Russian-speaking women engaged in commercial sex in Finland

This article explores how Russian-speaking women engaged in commercial sex in Finland understand home in relation to their experience of mobility and engagement in commercial sex. As it examines the mobility of those engaged in commercial sex, it moves away from trafficking or forced migration, and focuses on everyday experiences of home, ownership and self-care. The research is based on semi-structured interviews and ethnographic field work conducted in NGOs and commercial sex venues in Finland. It shows how by investing in private property, the women use their earnings from commercial sex to create their own spaces of comfort and personal pleasure, within the context of mobility, and how the inability to secure a material dwelling makes their sense of home more transient and unstable.

Self-Care Experiences and Practices of Women with Breast Cancer in Colombia

Self-Care Experiences and Practices of Women with Breast Cancer in Colombia

Life with a urostomy: A phenomenological study

AimTo explore the experiences of self-care of patients with urostomy and to identify the influencing factors of self-care. BackgroundThe creation of a urostomy results in the loss of an important bodily function and an alteration of the body image and causes physical, psychological, and social changes in the lifestyle through the adjustment and management of the new condition. In literature, there are few studies that analyze the lifestyle of people with urostomy. MethodsIn this qualitative design, an interpretative phenomenological analysis was used. Eleven people living with urostomies took part in semi-structured interviews consisting of open-ended questions about their self-care experience. Data were collected between March and September 2016. ResultsSix themes and twelve subthemes emerged from the data analysis. The themes were: Surgery impact, body image, daily and social-life activities, stoma and sexuality, managing stoma education, family and friends' support. ConclusionsThis study highlights the impact a stoma has on people's lives. This impact should be absorbed with personalized education before the surgery with the eventual need of a continuous and planned educational course respecting the patients' needs. This study shows that a continuous and planned educational plan is crucial for patients living with urostomies. Therefore, nurses should provide patients an adequate support and a personalized education program to cope with ostomy.

Expectations and Experiences of Follow-up and Self-Care After Living Kidney Donation: A Focus Group Study.

Ensuring donor wellbeing warrants ongoing monitoring after living kidney donation. However, there is considerable variability in donor follow-up processes, including information provided to donors regarding self-care. Loss to follow-up is common, suggesting that the aims and benefits of monitoring and follow-up may not be apparent. We aimed to describe the experiences and expectations of living kidney donors regarding follow-up and self-care after donation. Participants from 3 transplant centers in Australia and Canada participated in 14 focus groups (n = 123). Transcripts were analyzed thematically. We identified 4 themes: lacking identification as a patient (invincibility and confidence in health, immediate return to normality, avoid burdening specialty services, redundancy of specialist attention, unnecessary travel), empowerment for health (self-preservation for devastating consequences, self-advocacy and education, needing lifestyle advice, tracking own results), safety net and reassurance (availability of psychosocial support, confidence in kidney-focused care, continuity and rapport, and access to waitlist priority), and neglect and inattention (unrecognized ongoing debilitations, primary focus on recipient, hospital abandonment, overlooking individual priorities, disconnected from system, coping with dual roles, and lacking support for financial consequences). Living kidney donors who felt well and confident about their health regarded specialist follow-up as largely unnecessary. However, some felt they did not receive adequate medical attention, were prematurely detached from the health system, or held unresolved anxieties about the consequences of their decision to donate. Ongoing access to healthcare, psychosocial support, and education may reassure donors that any risks to their health are minimized.

Maintaining Stability in the Face of Adversity: Self-Care Practices of Human Trafficking Survivor-Trainers in India

Within the human rights organization, Kolkata Sanved, survivors of human trafficking used dance/movement therapy (DMT) based techniques to empower other survivors, fulfilling the dual role of survivor and provider. This transcendental phenomenological study explored the lived experiences of self-care for human trafficking survivors in Kolkata, India, working with other survivors. Semi-structured interviews were the primary mode of data collection. Artistic methods were included to engage participants in movement to further reflect on their experiences of self-care. To analyze the interviews, Moustakas’ (Phenomenological research methods, SAGE Publications, Thousand Oaks, 1994) modification of the van Kaam method of analysis of phenomenological data was implemented. Findings revealed common self-care practices among the participants that contributed to their stability. Self-care practices minimized participants’ re-traumatization when working with other survivors. This study further suggested the use of DMT and body-based practices for self-care within community-based organizations employing peer-provider models.

Innovative Use of Service-Learning to Enhance Baccalaureate Nursing Education.

Service-learning is an established pedagogical approach to nursing education found primarily in community nursing. With changing health care landscapes, the expansion of service-learning projects throughout the nursing program provides opportunities to enrich assessment and critical thinking and amplify exposure to determinants of health. Implementing service-learning in foundational nursing courses allows students to be challenged with the application of complex care management within a context of caring, cultural competence, social responsibility, and self-care initiatives. Integrating service-learning throughout the nursing curriculum has the potential to make positive, sustainable changes within a community, while simultaneously preparing students to view clients holistically, think critically, and develop cultural competence. Enhancing nursing curriculum by integrating service-learning opportunities can strengthen the learning experience and foster concepts of caring, social responsibility, cultural competence, and self-care. Working with community leaders from diverse groups can lead to sustainable projects that simultaneously benefit the community and nursing education. [J Nurs Educ. 2017;56(9):560-563.].

The effect of guided reflection on heart failure self-care maintenance and management: A mixed methods study

ObjectiveEvaluate the effect of structured, guided reflection on patient descriptions of self-care maintenance and management. BackgroundInadequate HF self-care behaviors are linked to hospitalizations. Symptom monitoring and recognition are precursors to adequate HF self-care. Reflection on actions taken during HF exacerbations may lead to insights and future changes in HF self-care maintenance and management. MethodsOne-group mixed method pre-test/post-test design. Following cognitive screening, self-care maintenance and management was measured prior to the intervention at a home visit one-week after hospital discharge, and one-month post intervention. Qualitative data consisted of audiotaped individual interviews with participants, field notes and reflective diaries kept by patients. ResultsThe results (N = 10) demonstrate large effect sizes and increases in self-care maintenance (69.9 vs 79.6, d = 1.04) and management (47.2 vs 63.9, d = 2.53) scores after intervention. Eight themes emerged from the data that reflected the HF participant’s experience of self-care. Reflection evoked emotions around concerns for family and mortality. Participants linked symptoms experienced with contextual factors which facilitated discussion about changing future actions. ConclusionsPurposeful reflection may be necessary for the development of self-care. Guided reflection on previous actions that includes contextual considerations may also play a role in enhancing self-care management by allowing the person to more fully understand the illness experience.

A study on Self-Care Experience of Patients with Atrial Fibrillation

A study on Self-Care Experience of Patients with Atrial Fibrillation

Unmet Primary Care Needs in Diabetic Patients with Multimorbidity in a Medically Underserved Area.

Background:Diabetic patients with multimorbidity in medically underserved minority communities are less engaged in primary care and experience high emergency department (ED) utilization. This study assesses unmet primary care needs among diabetic patients in a medically underserved area (MUA).Community Context:A suburb of Memphis—Whitehaven, Tennessee (Shelby County, ZIP codes 38109 and 38116)—majority African American (96.6%) with 30.5% below the poverty level.Methods:Community case study using multiple data sources including diabetes registry, individual interviews, focus groups, and a survey of 30 ED patients with diabetes and multimorbidity.Results:Diabetes registry data indicated that 95.5% of 5723 diabetic patients had multimorbidity. Over 91.5% were uncontrolled at some point in 2014 to 2015. Only 83% of patients with diabetes and multimorbidity reported having a primary care provider (PCP) and those without a PCP were more likely to report delays in needed care. Patients expressed strong interest in health coaching (88%) and receiving text messages from the doctor’s office (73%). Individual patient interviews (n = 9) and focus groups (n = 11) revealed common primary care and self-care experiences and needs including diabetes education, improved patient–provider communication, health-care access and coverage, and strengthened primary care and community.Conclusion:This study demonstrates that almost 1 in 5 ED complex diabetic patients in an MUA do not have a PCP, and that difficulty accessing primary care often results in patients forgoing needed care. Qualitative findings support these conclusions. These results suggest that primary care capacity and infrastructure to support diabetes self-care need strengthening in MUAs.

Heart failure patients' experiences of non-pharmacological self-care

Background: Heart failure self-care is important yet often sub-optimal. This literature review identifies and analyses the literature on heart failure patients' experiences of non-pharmacological self-care. Methods: The literature was searched in April 2015 using EBSCO Host. The World Health Organization (WHO) (2003) dimensions of adherence framework was used for data analysis. Results: The identified literature (14 primary articles; 4 literature reviews) was heavily weighted towards patient-related factors, namely acceptance of diagnosis, bio-behavioural variables and decision-making characteristics. Poor symptom recognition/management and the presence of comorbidities (specifically depression) were common condition-related factors highlighted as barriers to self-care. Lifestyle factors (therapy-related dimension) and professional support (health system/team dimension) were briefly described. Conclusions: This narrative literature review highlighted that heart failure self-care regimes are complex and often challenging to maintain. Further qualitative research regarding the therapy-related and health system-related factors would shed light on individual variations of and barriers to self-care.