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"Delivering knowledge and advice": Healthcare providers' experiences of their interaction with patients' management of rheumatoid arthritis.
Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. ADULT.
2011 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, -9 p.Article in journal (Refereed) Published
Abstract [en]

Rheumatic diseases are often chronic and involve a lifetime of suffering. The focus of rheumatology care is to support patients to manage their lives and master their disease. Healthcare providers and patients have different views on the consequences of living with rheumatic diseases and patients are reporting unmet healthcare needs. There is a need to integrate providers' perspective to develop the quality of rheumatology care. The aim was to explore healthcare providers' experiences of their interaction with patients in their management of RA. Interviews with 18 providers from different clinical settings were analysed in accordance with the grounded theory method. A core category; Delivering knowledge and advice was found to be the most important task and involved providing the patient with information about the disease and appropriate forms of treatment. Healthcare providers' attitudes and patients' responses influenced the outcome of the delivery of knowledge and advice and three dimensions emerged; completed delivery, adjusted delivery and failed delivery. There were differences in the providers' experiences in their interaction with patients as well as in reflections on their role as the delivering part. There could be difficulties in the interaction when patients' expectations and preferences were not taken into account when giving advice. These findings highlight the importance of developing rheumatology care, as no provider or patient benefits if the delivery of knowledge and advice becomes a failed delivery. The healthcare organization must acknowledge the difficulties involved in the interaction with patients in their management of RA and find methods to develop a more person-centred approach to care.

Place, publisher, year, edition, pages
2011. Vol. 6, no 4, -9 p.
Keyword [en]
Grounded theory, healthcare provider, interaction, nursing, patient interaction, rheumatoid arthritis
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-16665DOI: 10.3402/qhw.v6i4.8473PubMedID: 22053161OAI: oai:DiVA.org:hj-16665DiVA: diva2:454461
Available from: 2011-11-07 Created: 2011-11-07 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Patients' and healthcare providers' experiences of the cause, management and interaction in the care of rheumatoid arthritis
Open this publication in new window or tab >>Patients' and healthcare providers' experiences of the cause, management and interaction in the care of rheumatoid arthritis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aim: The overall aim of this thesis was to explore and describe patients’ and healthcare providers’ experiences of the causes, management and interaction in the care of rheumatoid arthritis (RA). Method: The thesis is based on four studies. Studies I and II contain data from an epidemiologic project involving patients who were recently diagnosed with RA. The patients answered an open-ended question about their conception of the cause of their RA (Study I). Qualitative data from 38 patients were analysed using the phenomenographic approach in order to identify variation in conceptions. The results of Study I formed the basis for categorizing the conceptions of 785 patients in the search for patterns of background factors (Study II). Study III aimed to explore how patients experienced their management of RA in everyday life. Data were collected by interviews with 16 patients and analysed according to Grounded Theory (GT). In study IV, the aim was to explore healthcare providers’ experiences of their interaction with patients’ management of RA. Data were collected by interviews with 18 providers representing different professions and analysed using GT. Findings:  Patients’ conceptions of the cause of their RA revealed new aspects from the patient perspective that can complement pathogenetic models. Two descriptive categories emerged: consequences beyond personal control and overloaded circumstances, which included six categories of conceptions (Study I). The most common conceptions of the cause of RA were unexpected effects of events followed by work and family-related stress (Study II). Background factors that influenced the conceptions of the cause were age, sex and educational level. Patient management of RA involved using personal resources together with grasping for support from others in their striving for a good life. When linking these aspects together, four ways of management emerged: mastering, struggling, relying and being resigned (Study III). Healthcare providers’ experiences of their interaction with patients’ management shed light upon the important issue of delivering knowledge and advice. The providers’ attitudes constituted one cornerstone and patients’ responses the other. The providers reported that the interaction led to different outcomes: completed delivery, adjusted delivery and failed delivery. Conclusions: The findings contribute new knowledge from both patients’ and healthcare providers’ perspectives, which could be used to develop a more person-centred approach in rheumatology care. Person-centred care involves taking patients’ beliefs and values into account in addition to creating a trusting relationship between patient and provider. A successful person-centred approach requires an organisation that supports the person-centred framework.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2011. 77 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 23
Keyword
Rheumatoid arthritis, patient perspective, self-management, illness perception, patient-provider interaction, provider perspective, person-centred care
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-16740 (URN)978-91-85835-22-5 (ISBN)
Public defence
2011-12-09, Forum Humanum, Hälsohögskolan, Jönköping, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2011-11-17 Created: 2011-11-17 Last updated: 2011-11-17Bibliographically approved

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