Denne filen er hentet fra Lovisenberg diakonale høgskoles institusjonelle arkiv LDH Brage.Patients' experiences with changes in perceived control in chronic illness: A pilot study of the outcomes of a new health promotion program in community health care
Miriam Hjeldsbakken Engevold
Universitetet i Oslo
Kristin Heggdal
Universitetet i StavangerVed henvisning til publikasjonen, bruk fullstendig referanse:
BY: Miriam Hjeldsbakken Engevold and Kristin HeggdalAn increasing number of people worldwide are facing chronic illnesses. About 52 million people in Europe aged 55-74 report that they have a long-standing illness or health problem, while in the U.S. approximately 133 million people are affected (Harbers & Achterberg, 2012; National Health Council, 2014). Chronic illness has been defined as «the irreversible presence, accumulation, or latency of disease states or impairments that involve the total human environment for supportive care and selfcare, maintenance of function, and prevention of further disability» (Lubkin & Larsen, 2013, p. 6). Chronic illness disrupts many aspects of the individual's life, including physical, emotional, social, and vocational functioning (Taylor, 2009; World Health Organization, 2009). Some of the main challenges are the uncertainty and the loss of control arising from changes in health and functioning (Mishel, 1988(Mishel, , 1990Toombs, 1993). A main consequence is that many individuals who are diagnosed with a chronic illness are at risk of developing emotional problems such as depression, anxiety, and distress in addition to their physical discomfort (De Graaf & Bijl, 2002; Mittermaier, Dejaco, Waldhoer, Oefferlbauer-Ernst, Miehsler, Beier, Tillinger, Gangl, & Moser, 2004) The symptoms may appear as an unpleasant surprise to the person, they can be painful and frightening, fade away, and then appear again later, and the time before medical advice is sought may vary substantially. The person experiences the sensation that the previously ithooth functioning of the healthy body is being lost (Corbin, 2003;Frank, 2013;Leder, 1992). Uncertainty prevails, because there are numerous alternative interpretations of the meaning of the symptoms and reasons for their appearance. Questions patients have are: What type of illness it is? How it is going to develop? What are the possibilities for medical treatment? Uncertainty also concerns how the progression of the condition will affect the person's ability to participate in daily living activities, one's working capacity, and one's social functioning. Mishel (1981, p. 1) defined uncertainty as a «cognitive state created when an event cannot be adequately defined or categorized due to lack of information.» This definition implies
1/19that the patient, the doctor, or other helpers do not know which factors cause the illness and therefore do not know how the problem can be diminished or «solved.» As a result, the affected person has to live with symptoms that seem to be inexplicable, and he or she often lacks the means to handle th...