hh.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy: a phenomenographic study
School of Health Sciences, Jönköping University.ORCID iD: 0000-0002-4341-660X
Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.ORCID iD: 0000-0002-6294-538X
School of Health Sciences, Jönköping University.
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
2010 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 5, no 2, p. 5146-1-5146-10Article in journal (Refereed) Published
Abstract [en]

Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseases experience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Four ways of understanding the patients' experience of their subcutaneous anti-TNF therapy and independence of a nurse emerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achieving independence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In their strive for independence, patients progress by learning about and participating in drug treatment, after which they experience that the injections make them independent.

Place, publisher, year, edition, pages
London: Taylor & Francis, 2010. Vol. 5, no 2, p. 5146-1-5146-10
Keywords [en]
independence, patient, phenomenography, rheumatology nurse, self-administration, subcutaneous anti-TNF therapy
National Category
Nursing Rheumatology and Autoimmunity Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:hh:diva-5652DOI: 10.3402/qhw.v5i2.5146ISI: 000281886700011PubMedID: 20616887Scopus ID: 2-s2.0-81255192467OAI: oai:DiVA.org:hh-5652DiVA, id: diva2:350819
Available from: 2010-09-11 Created: 2010-09-11 Last updated: 2022-06-07Bibliographically approved
In thesis
1. Person-centred care in rheumatology nursing in patients undergoing biological therapy: An explorative and interventional study
Open this publication in new window or tab >>Person-centred care in rheumatology nursing in patients undergoing biological therapy: An explorative and interventional study
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim was to explore and evaluate rheumatology nursing from a person-centred care perspective in patients undergoing biological therapy.

Method: This thesis focuses on patients with chronic inflammatory arthritis (CIA) who were undergoing biological therapy at a rheumatology clinic in Sweden. Papers I and II had an explorative descriptive design with a phenomenographic approach. The 40 participants were interviewed about their dependence on or independence of a nurse for the administration of their infusions or injections. Paper III had a randomised controlled design involving 107 patients in the trial.  The objective of the intervention was to replace every second monitoring visit at a rheumatologist-led clinic by a visit to a nurse-led rheumatology clinic, based on person-centred care. Paper IV had an explorative descriptive design with a qualitative content analysis approach. Interviews were conducted with 20 participants who attended the nurse-led rheumatology clinic.

Findings: Dependence on a rheumatology nurse for administration of intravenous infusions was described as invigorating due to the regular contact with the nurse, which provided security and involvement (paper I). Independence of a nurse for subcutaneous injections was understood by the patients in different ways and was achieved by struggling to cope with injecting themselves, learning about and participating in drug treatment (paper II). Patients with stable CIA receiving biological therapy were monitored by a nurse-led rheumatology clinic without any difference in outcome when compared to monitoring carried out at a rheumatologist-led clinic, as measured by the Disease Activity Score 28. Replacing one of the two annual rheumatologist outpatient follow-up visits by a visit to a nurse-led clinic for the monitoring of biological therapy was found to be safe and effective (paper III). A nurse-led rheumatology clinic, based on person-centred care, added value to the follow up care of patients with stable CIA undergoing biological therapy by providing a sense of security, familiarity and participation (paper IV).

Conclusion: This thesis contributes a valuable insight into person-centred care as the core of rheumatology nursing in the area of biological therapy. The rheumatology nurse adds value to patient care when she/he gives patients an opportunity to talk about themselves as a person and allow their illness narrative to constitute a starting point for building collaboration, which encourages and empowers patients to play an active part in their biological therapy and become autonomous. A nurse who provides person-centred care and keeps the patients’ resources and needs in focus serves as an important guide during their healthcare journey.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, Jönköping University, 2013. p. 87
Series
Doctoral Thesis. Jönköping: School of Health Sciencese, Jönköping University, Dissertation Series, ISSN 1654-3602 ; 41
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hh:diva-25025 (URN)978-91-85835-40-9 (ISBN)
Public defence
2013-05-17, Forum Humanum, Hälsohögskolan, Jönköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-08-18 Created: 2014-04-11 Last updated: 2016-02-05Bibliographically approved

Open Access in DiVA

fulltext(506 kB)114 downloads
File information
File name FULLTEXT01.pdfFile size 506 kBChecksum SHA-512
4ad956f7efdd8cee57afb4c91f3a231fa0067466a833c7e3160ea05d06eda3ecfdafed55a5088a5c8cea9cf747d4b4bac4961a5df8399159a5236382de5d638f
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Larsson, IngridBergman, StefanFridlund, BengtArvidsson, Barbro

Search in DiVA

By author/editor
Larsson, IngridBergman, StefanFridlund, BengtArvidsson, Barbro
By organisation
Centre of Research on Welfare, Health and Sport (CVHI)
In the same journal
International Journal of Qualitative Studies on Health and Well-being
NursingRheumatology and AutoimmunityHealth Care Service and Management, Health Policy and Services and Health Economy

Search outside of DiVA

GoogleGoogle Scholar
Total: 114 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 256 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf