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Biomedical subjects

Kirsten Lomborg

Publications and source records attributed to Kirsten Lomborg.

4 recordsLinked to original sources
PubMed2005

Body care experienced by people hospitalized with severe respiratory disease.

AIM: The paper gives a theoretical account of experiences of assisted personal body care (APBC) in hospitalized patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: Body care has been identified as a central but underestimated area of nursing. Hospitalized patients with severe COPD suffer from breathlessness on exertion and are dependent on help with personal body care. Studies have described patient strategies for managing breathlessness and preferences regarding nursing care during hospitalization. Yet the problems that patients can experience because of their inability to manage personal body care by themselves have not previously been explored. This study explored patients' experiences of being assisted with personal body care. METHODS: A grounded theory methodology was used with a convenience sample of 12 patients. Data were gathered from participant observation of sessions of APBC, in-depth interviews after the observed sessions and measurement of breathlessness perceived by patients before and after the sessions. FINDINGS: The patients perceived body care as a significant daily activity that needed to be carried out in order to preserve their integrity. Dependency and breathlessness, however, impeded the performance of body care activities and patients were struggling for self-preservation. They managed APBC by using a threefold strategy of not letting go, coping with dependency, and minimizing the risk of escalating breathlessness. Two dilemmas were identified as being inherent to the strategy. CONCLUSION: Increased knowledge of the complexities involved in providing assistance might improve nurses' ability to facilitate patients in managing APBC. Dependency is a central issue to address in order to support patients' efforts to preserve integrity and resolve dilemmas inherent to the strategy they use.

Adaptation, Psychological↗
PubMed2005

Curtailing: handling the complexity of body care in people hospitalized with severe COPD.

Assisted personal body care (APBC) tends to be regarded as an unproblematic nursing activity with little professional challenge. For severely ill patient diagnosed with chronic obstructive pulmonary disease (COPD) daily bathing and washing is, however, a significant self-preserving activity that requires substantial efforts on the part of both patients and nurses. The aim of this study was to report on the complex pattern of APBC in hospitalized patients with severe COPD and highlight significant characteristics that should be considered in clinical practice in order to support patients' comfort and well-being. The study used a grounded theory design with a generative and constant comparative approach. The sample consisted of 12 cases of nurse-patient interaction, based on data from participant observation of sessions of APBC, measures of patient's perceived degree of breathlessness and individual interviews with patients and nurses after the sessions. Findings show that APBC in hospitalized patients with severe COPD is a complex integrated pattern of body care activities that can proceed with a greater or lesser degree of success. The main problem is how to keep the patient's breathing under control while optimizing comfort and well-being. Curtailing addresses this problem. Curtailing is a subtle, purposeful balancing of protection from breathlessness and promotion of patients' present and future functional capacity in order to preserve their integrity. The idea that body care is a simple task belonging to patients' private daily lives may obscure the importance of determining a mutual nurse-patient agenda and the professional nurse responsibility may consequently be nebulous. Finding in this study will contribute to the development of a comprehensive and detailed understanding of the APBC and suggest the need for further investigation of the interaction perspective.

Activities of Daily Living↗
PubMed2003

Truth and validity in grounded theory -- a reconsidered realist interpretation of the criteria: fit, work, relevance and modifiability.

Grounded theory is a frequently used approach in nursing research. Over the years the methodology has developed in different directions with ambiguous answers to questions of truth and validity. This ambiguity influences the interpretation of the criteria for quality judgement of grounded theories: fit, work, relevance and modifiability. In particular, the criterion fit seems to be caught in a vacuum between different epistemological and ontological positions. Fit can be interpreted either from a realist or from a nonrealist position but both present problems. A realist position is problematic if it insists on an immutable empirical world and ignores the social and psychological aspects of human life. A nonrealist position can either be argued to rely on hidden realist assumptions and therefore to be inconsistent, or it can be relativistic, opening up the possibility of 'anything goes' attitudes in research and solipsistic confirmations of the world view of researchers with little or misleading practical impact. A reconsideration of the realist position is suggested, in which validity is regulated by the social constructed reality 'as it really is'. From this position fit is a matter of correspondence to facts in social reality. The criteria work, relevance and modifiability are argued to support the fitness of a theory, and to be useful in the broader evaluation of the quality of grounded theories.

Humans↗