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Older persons’ experiences of Reflective STRENGTH-Giving Dialogues – ‘It's a push to move forward’
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). School of Health and Welfare, Jönköping University, Sweden. (Välbefinnande vid långvariga hälsoproblem (WeLHP), Wellbeing in Long-term Health Problems)ORCID iD: 0000-0001-8554-352X
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). (Välbefinnande vid långvariga hälsoproblem (WeLHP), Wellbeing in Long-term Health Problems)ORCID iD: 0000-0002-2671-1041
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). School of Health and Welfare, Jönköping University, Sweden. (Välbefinnande vid långvariga hälsoproblem (WeLHP), Wellbeing in long-term health problems)ORCID iD: 0000-0003-1819-0896
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). College of Nursing, University of Rhode Island, Kingston, RI, USA. (Välbefinnande vid långvariga hälsoproblem (WeLHP), Wellbeing in long-term health problems)ORCID iD: 0000-0003-3970-1288
2021 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 35, no 3, p. 779-787Article in journal (Refereed) Published
Abstract [en]

Rationale: Experiences of the innovative method Reflective STRENGTH-Giving Dialogue (STRENGTH), which is grounded in a lifeworld perspective and developed to improve quality of care, is described in this study. Innovative thinking in developing health and social care, which may include digital solutions, is required to ensure a meaningful and dignified life in old age. Aim: The aim of this study was to describe experiences of the intervention Reflective STRENGTH-Giving Dialogue from the perspective of older persons living with long-term health problems. Method: Individual qualitative interviews were conducted with 27 older persons who participated in the intervention. The older persons wrote notes from each dialogue in booklets, and the booklets became part of the study data, analysed with a Reflective Lifeworld Research approach. Results: STRENGTH is experienced as an opportunity to reflect upon life and identify small and large life projects. Dialogues that lead to change in thoughts and actions influence the older persons' well-being, sense of balance, joy and meaning in life. There is an experience of STRENGTH as a starting point and a push to move forward in an effort to experience joy and meaning in life when living with long-term health problems. Conclusions: STRENGTH has the potential to contribute to quality improvement in person-centred care and enhance meaning in life for older persons living with long-term health problems. However, the use of a digital tool in this particular context poses challenges that must be considered. 

Place, publisher, year, edition, pages
John Wiley & Sons, 2021. Vol. 35, no 3, p. 779-787
Keywords [en]
dialogue, digitalisation, intervention, long-term health problem, older person, person-centred care, phenomenology, qualitative research, reflective lifeworld research, STRENGTH, aged, article, female, human, human experiment, interview, male, social care, thinking, total quality management, wellbeing
National Category
Nursing
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
URN: urn:nbn:se:his:diva-18912DOI: 10.1111/scs.12892ISI: 000555802600001PubMedID: 32761648Scopus ID: 2-s2.0-85089090715OAI: oai:DiVA.org:his-18912DiVA, id: diva2:1457789
Note

CC BY 4.0

First published: 05 August 2020

Available from: 2020-08-13 Created: 2020-08-13 Last updated: 2023-01-20Bibliographically approved
In thesis
1. Striving for meaning in a diminishing world: Older persons’ experiences of reflective STRENGTH-giving dialogues including a digital tool
Open this publication in new window or tab >>Striving for meaning in a diminishing world: Older persons’ experiences of reflective STRENGTH-giving dialogues including a digital tool
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The Reflective STRENGTH-Giving Dialogue (STRENGTH) method was developed, grounded in a lifeworld perspective, with a focus on identifying and meeting older persons’ needs for the promotion of health and well-being. In this thesis, STRENGTH, including the digital tool SelfSTRENGTH, was tested in the context of community-dwelling older persons living with long-term health problems.

The overall aim was to describe how life with long-term health problems is experienced and influenced by the Reflective STRENGTH-Giving Dialogue intervention, including the SelfSTRENGTH app, by community-dwelling older persons.

The research was conducted based on a reflective lifeworld approach, through qualitative and quantitative method studies. Three of the studies had a qualitative, descriptive, and inductive design based on individual interviews and reflection notes with the older persons in the intervention group (Papers I–III). Analysis was conducted using phenomenology (Papers I–II), and phenomenography (Paper III). One study had a quasi-experimental pretest-posttest no-treatment control group design (Paper IV), and was analyzed using nonparametric paired statistics. Altogether, 60 older persons in the fourth age participated in the studies.

The finding showed, according to self-reports, that STRENGTH immediately and significantly reduced the impact of health problems on daily life, and increased well-being after each single dialogue. The content and outcome of the dialogues are affected by intersubjectivity, which is influenced by the healthcare professional (HCP) and the older person’s ability, as well as the relationship between them. STRENGTH dialogues that have an existential dimension are described as a starting point to provide a “push” toward joy and meaning. When the understanding of an older person’s holistic situation, including the past, present, and future, is tactfully and sensitively challenged with reflection and an emphasis on possibilities, the dialogues support joy and meaning in life. Dialogues of this nature have been lacking, as older persons may choose not to have that conversation with their family or HCPs, and HCPs may not attend to the older person’s existential needs and concerns. It is important when living in the feeling of a diminishing world for older persons to be involved in decisions that concern their lives and care, and to engage in life projects that improve well-being. This is made possible through the dialogues and use of the SelfSTRENGTH app. However, use of the app is hindered by resistance to digital technology and the occurrence of health problems.

To foster healthy ageing, HCPs need increased knowledge and favorable conditions for caring conversations and provision of digital support that older persons with long-term health problems need for participation in a digital society.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2022. p. 111
Series
Dissertation Series / Jönköping University, School of Health and Welfare, ISSN 1654-3602 ; 110
Keywords
Caring conversation, complex intervention, patient perspective, phenomenology, phenomenography, quasi-experimental design, reflected lifeworld research
National Category
Gerontology, specialising in Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Wellbeing in long-term health problems (WeLHP)
Identifiers
urn:nbn:se:his:diva-21045 (URN)978-91-88669-09-4 (ISBN)
Public defence
2022-04-29, Insikten, Portalen, Kanikegränd 3B, Skövde, 13:00 (English)
Opponent
Supervisors
Available from: 2022-04-08 Created: 2022-04-08 Last updated: 2023-01-10Bibliographically approved

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Åberg, CeciliaBerglund, MiaHallgren, JennyGillsjö, Catharina

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