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Striking a balance - health experiences of male ambulance personnel with musculoskeletal symptoms: a grounded theory
University of Gävle, Centre for Musculoskeletal Research. Department of Nursing, Umeå University, Umeå, Sweden.
Department of Nursing, Umeå University, Umeå, Sweden.
University of Gävle, Centre for Musculoskeletal Research.
Department of Nursing, Umeå University, Umeå, Sweden.
2007 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 44, no 5, 770-779 p.Article in journal (Refereed) Published
Abstract [en]

Background: Musculoskeletal disorders (MSD) are a dominant cause to long-term sick leave and early retirement. Some occupational groups are more affected than others and ambulance personnel are among them. Despite a vast amount of research, only a small part focuses the experiences of the affected.

Objectives: The aim of the study was to explore the experience of illness and wellness in ambulance personnel with musculoskeletal symptoms.

Design: An emerging design was used in accordance with Grounded Theory.

Participants: Informants in the study were ten men with musculoskeletal symptoms, working as ambulance personnel at an ambulance station located in a mid-sized city in Sweden.

Methods: Narrative interviews were performed, parallel to a constant comparative analysis.

Results: The study resulted in a model, which describes the experience of illness and wellness as characterised by an effort to strike a balance. Wellness through nurturing appeared parallel to encountering illness as an experience and a threat. Accepting and handling illness was of importance to maintaining wellness, and wellness through nurturing was the motivation for accepting and handling illness.

Conclusions: Enhancing the understanding of wellness and illness makes it possible to avoid undermining the meaningfulness that support accepting and handling illness, and by understanding different aspects of illness prevention can become facilitated. This is of importance as other aspects than solely physical have shown to be similarly important in the development of MSD.

Place, publisher, year, edition, pages
2007. Vol. 44, no 5, 770-779 p.
Keyword [en]
Adaptation, Psychological, Adult, Ambulances, Attitude of Health Personnel, Attitude to Health, Burnout, Professional etiology psychology, Emergency Medical Technicians psychology, Humans, Job Satisfaction, Male, Men psychology, Middle Aged, Models Psychological, Musculoskeletal Diseases etiology prevention control psychology, Narration, Nursing Methodology Research, Occupational Diseases etiology prevention control psychology, Questionnaires, Retirement, Self Care methods psychology, Self Concept, Sick Leave, Sick Role, Sweden
National Category
Environmental Health and Occupational Health
Identifiers
URN: urn:nbn:se:hig:diva-2739DOI: 10.1016/j.ijnurstu.2006.02.007ISI: 000247990000013PubMedID: 16600239Scopus ID: 2-s2.0-34250013627OAI: oai:DiVA.org:hig-2739DiVA: diva2:119401
Available from: 2007-11-28 Created: 2007-11-28 Last updated: 2016-10-30Bibliographically approved
In thesis
1. Balancing intrusive illness: the experiences of people with musculoskeletal problems
Open this publication in new window or tab >>Balancing intrusive illness: the experiences of people with musculoskeletal problems
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of the present thesis was to explore and describe the health experiences of men and women with musculoskeletal problems. The specific aims of the four papers were: (I) to explore the experience of illness and wellness among ambulance personnel with musculoskeletal symptoms; (II) to explore the experience of illness and wellness among female health care personnel with musculoskeletal symptoms; (III) to explore the experience of bodily illness among people with musculoskeletal problems in the neck-shoulder region, and; (IV) to investigate the symptoms described by people with non-specific neck-shoulder problems, to investigate the method of development of neck-shoulder questionnaires that assesses pain and other symptoms, to analyse the content and items of these questionnaires, and to compare the findings.

The overall findings show that the occupationally active men and women with MSDs were “striving for balance” (I-II), that the disease course of chronic neck-shoulder disorders was characterised by “uncontrollable fluctuations” (III), and that most neck-shoulder questionnaires had a low correspondence to the variety of symptoms experienced during this course (IV). In the process of striving for balance (I-II), the informants’ health experiences were not a state of either wellness or illness, but of both, in varying degrees at different times. The balancing started when illness became too intrusive, and was a process of minimising the impact of illness by accepting and handling it, while attaining and maintaining wellness to feel well enough. When striving for balance, the interviewees kept on working to continue being nurtured at the same time as they made different efforts directed at minimising the impact of their illness. For both men and women, illness was characterised by disembodiment, vulnerability, and exhaustion. The illness experiences were counterbalanced by wellness, where some differences could be recognised between the men and the women. Study III further explored the experiences of bodily illness, focusing on people with chronic musculoskeletal disorders in the neck-shoulder region. The course of the disorder was described as characterised by uncontrollable fluctuations, and it usually developed from insidious symptoms to a state of constant discomfort. The participants experienced calmer periods during the course, but intermittent events of increasing illness were always lying in wait, with periodic moments of consuming intensity. In the interviews included in study IV a variety of symptoms were expressed, which indicated a bodily, mental, and emotional engagement, which included more general and more severe symptoms than are usually related to neck-shoulder disorders. Few of the questionnaires were developed using the experiences of the affected. Taken as a whole, did the questionnaires cover many of the symptoms of the interviewees, but each individual questionnaire only included a few. The fluctuations and nuances of symptoms were rarely considered. The correspondence between individual questionnaires and the experiences of those affected was most often low. This thesis reveals other aspects of health than just bodily experiences as important among occupationally active people with MSDs. It also provides a description of the disease course, and an indication of possibilities for improvement of neck-shoulder questionnaires

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2007. 54 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1106
Keyword
musculoskeletal problems, health experiences, illness, wellness, grounded theory, content analysis, balancing, disease course, uncontrollable fluctuations, symptoms
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hig:diva-2741 (URN)978-91-7264-335-2 (ISBN)
Public defence
(English)
Opponent
Supervisors
Available from: 2008-05-27 Created: 2008-05-27 Last updated: 2011-09-27Bibliographically approved

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