Thesis (M. A.)--University of British Columbia, 2006. / Includes bibliographical references.

Bakgrund: Diabetes är en kronisk som ökar i omfattning i världen. Behandlingsalternativen är insulin och läkemedel samt egenvård. Egenvård är nödvändig för att minska risk för framtida komplikationer till följd av sjukdomen och innebär framförallt förändrade kost-och motionsvanor. Metod: En kvalitativ litteraturöversikt. Vetenskapliga artiklar med kvalitativ ansats har analyserats. Syfte: Belysa patienters upplevelser av egenvård vid diabetes typ-2. Resultat: I analysen framkom fyra teman 1) Att få en sjukdomsdiagnos, 2) utmaningar gällande kost-och motionsvanor och 3) det professionella stödet 4) stöd från anhöriga. Konklusion:Egenvård är en process som kräver mycket stöd från anhöriga och sjuksköterskan. Stödet från sjuksköterskan i form av stöttning och vägledning i sjukdomen och stöd från anhöriga genom uppmuntran och motivation. Bristande stöd från dessa leder till bristande egenvård. / Background: Diabetes is a chronic disease that is increasing in the world. The treatment options are insulin and medication as well as self management. Self management is necessary to reduce the risk of future complications as a result of the disease and primarily involves changes in diet and exercise habits. Method: A qualitative literature review. Scientific articles with a qualitative approach have been analyzed. Aim: To shed light on patients' experiences of self management in type 2 diabetes. Findings: The analysis revealed three themes 1) Being diagnosed with a disease, 2) Struggles regarding food and exercise habits 3) the professional support and 4) support from relatives. Conclusion: : Self management is a process that requires a lot of support from relatives and the nurse. The support from the nurse in the form of guidance within the disease and support from relatives through encouragement and motivation. Lack of support from these leads to lack of self management

Le discours commun plaide en faveur l'autonomie du malade. Pourtant soigner la maladie chronique révèle aussi des attachements. C'est ce que nous proposons de mettre en évidence, à travers notre thèse qui prend pour exemple le diabète et envisage, à travers le développement de la notion de travail d'équipement, de questionner l'autonomie, qui est loin d'aller de soi. A partir d'entretiens, d'observations de terrain et d'objets, de recherche de traces, nous interrogeons des pratiques telles que l'éducation thérapeutique, l'introduction des médicaments, des équipements (lecteur de glycémie, pompe à insuline). Tous ces éléments sont autant de médiations, pour le malade, son entourage, les professionnels de santé, les associations de malades, qui influencent le cours de la vie avec la maladie. Le travail d'équipement permet de faire le lien entre la sociologie de la santé et de la maladie, l'interactionnisme, la phénoménologie et la sociologie de l'acteur réseau. Il offre une grille de lecture de la maladie chronique et du soin, au regard de tous les équipements qui contribuent à la prise en charge la maladie. Il permet de définir ce qu'est l'autonomie dans le cadre d'une maladie qui tient le malade et va plus loin ouvrant vers la construction identitaire de l'homme-avec-la-maladie. / Common speech calls for patient autonomy. Yet chronic illness care also reveals attachments. This is what we propose to highlight, through our thesis that takes for example diabetes and plans through the development of the concept of ‘the equipping work', questioning the autonomy, which is far to go self. From interviews, field observations, objects screening, and search of traces, we interrogate such practices as therapeutic education, the introduction of drugs and equipment (glucometer, insulin pump). These elements are all mediations, for the patient, family members, health professionals, patient organisations, which influence the course of living with the disease. Equipping can make the link between the sociology of health and illness, symbolic interactionism, phenomenology and the actor network theory. It provides a grid of chronic illness and care, with all the equipements that contribute to the management of disease. It allows defining autonomy despite the strength of disease ties and leads to rebuild the identity of the man-with-the-sickness.

Bakgrund: DMT2 debuterar vanligtvis hos vuxna personer som har haft dåliga hälsovanor eller har genetiska anlag för sjukdomen. Patienter med DMT2 kan få komplikationer på grund av brist på egenvård. Sjuksköterskan har en viktig roll för patienter med diabetes och det är att se till att patienterna förstår innebörden att leva med DMT2 och förespråka vikten av egenvård. Dessutom kan sjuksköterskan behöva ingripa om egenvården upplevs omöjlig att utföra. Syfte: Syftet var att beskriva personers upplevelse av egenvård vid diabetes typ 2.  Metod: Metoden var en litteraturöversikt. Litteratursökningen genomfördes i databaserna Cinahl Complete och PubMed. Tio stycken kvalitativa vetenskapliga originalartiklar inkluderades i resultatet. Resultat: I resultatet framkom tre teman; svårigheter med förändringar i livet, vikten av stöd samt betydelsen av kunskap. Sammanfattning: DMT2 är en sjukdom som kräver mycket egenvård och förändringar i livet vilket blir en utmaning för individen. Slutsatsen som författarna kommit fram till är att närstående såväl som sjukvård är viktiga faktorer för patienter med DMT2. Stöd är viktigt för att stärka motivation att utveckla förmågan till egenvård på bästa sätt. Sjuksköterskor har en betydande roll i att stödja diabetespatienter och deras anhöriga under sjukdomsförloppet. / Background: DMT2 usually debuts in adults who have had poor health habits or have genetic predispositions to the disease. Patients with DMT2 may have complications due to lack of self-care. The nurse has an important role for patients with diabetes and that is to make sure that patients understand the consequences of living with DMT2 and advocate the importance of self-care. In addition, the nurse may need to intervene if self-care is perceived as impossible to perform. Aim: The purpose was to describe personal experience of self-care in type 2 diabetes. Method: The method was a literature review. The literature search was performed in the databases Cinahl Complete and Pub Med. Ten qualitative scientific original articles were included in the result. Results: The results are reported according to the three themes that emerged in the data analysis: difficulties with changes in life, The importance of the supportive significance of knowledge. Conclusion: DMT2 is a disease that requires a lot of self-care and changes in life, which becomes a challenge for the individual. The conclusion that the authors have come to is that relatives as well as healthcare are important factors for patients with DMT2. Support is important to strengthen motivation to develop the ability to self-care in the best way. Nurses have a significant role in supporting diabetic patients and their relatives during the course of the disease.

Background: Patient empowerment is viewed as a priority by policy makers, patients and practitioners worldwide. Although there are a number of measures available, none have been developed specifically for patients in the UK with long-term conditions. It is the aim of this study to report the development and preliminary validation of an empowerment instrument for patients with long-term conditions in primary care.Methods: The study involved three methods. Firstly, a systematic review was conducted to identify existing empowerment instruments, and to describe, compare and appraise their content and quality. The results supported the need for a new instrument. Item content of existing instruments helped support development of the new instrument. Secondly, empowerment was explored in patients with long-term conditions and primary care practitioners using qualitative methods, to explore its meaning and the factors that support or hinder empowerment. This led to the development of a conceptual model to support instrument development. Thirdly, a new instrument for measuring empowerment in patients with long-term conditions in primary care was developed. A cross-sectional survey of patients was conducted to collect preliminary data on acceptability, reliability and validity, using pre-specified hypotheses based on existing theoretical and empirical work. Results: Nine instruments meeting review inclusion criteria were identified. Only one instrument was developed to measure empowerment in long-term conditions in the context of primary care, and that was judged to be insufficient in terms of content and purpose. Five dimensions (‘identity’, ‘knowledge and understanding’, ‘personal control’, personal decision-making’, and ‘enabling other patients’) of empowerment were identified through published literature and the qualitative work and incorporated into a preliminary version of the new instrument. A postal survey achieved 197 responses (response rate 33%). Almost half of the sample reported circulatory, diabetic or musculoskeletal conditions. Exploratory factor analysis suggested a three factor solution (‘identity’, ‘knowledge and understanding’ and ‘enabling’). Two dimensions of empowerment (‘identity’ and ‘enabling’) and total empowerment showed acceptable levels of internal consistency. The measure showed relationships with external measures (including quality of chronic illness care, self-efficacy and educational qualifications) that were generally supportive of its construct validity.Conclusion: Initial analyses suggest that the new measure meets basic psychometric criteria and has potential for the measurement of patient empowerment in long-term conditions in primary care. The scale may have a role in research on quality of care for long-term conditions, and could function as a patient-reported outcome measure. However, further validation is required before more extensive use of the measure.