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Striving for balance: a grounded theory study of health experiences of nurses with musculoskeletal problems.
University of Gävle, Centre for Musculoskeletal Research. 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 8, 1379-1390 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Musculoskeletal disorders (MSD) are one of the major causes of the high levels of long-term sickleave and early retirement, and healthcare personnel are among the occupational groups most affected. Only limited research in the area has focused on the experiences of those affected, and to increase the understanding of MSD, all dimensions of the health experiences need to be taken into consideration. OBJECTIVES: The aim of this paper was to explore the experiences of illness and wellness among female healthcare personnel with musculoskeletal symptoms. DESIGN: A qualitative grounded theory approach guided the study in data collection and analysis. SETTINGS: Medical and surgical ward units at three hospitals; one university hospital and two minor hospitals. PARTICIPANTS: Eight women, registered nurses and nursing aides, with neck, shoulder and/or back problems in early stages. METHODS: A grounded theory approach was used with narrative thematic interviews and parallel data analysis with constant comparisons. RESULTS: The analysis revealed a process of striving to reach a balance between illness and wellness, through accepting and handling illness. Illness appeared as a threat and an experience, while experiences of wellness were simultaneously nurtured. The informants were striving for balance through an inner reasoning leading to acceptance and by handling illness in various ways depending on the character of the illness. CONCLUSION: This paper indicates the diversity of the illness experience, the parallel importance of wellness, and the process of balancing these two in order to feel well enough. As previous research has shown that MSD has a multifactorial cause, a holistic view of health promotion, prevention and rehabilitation may provide a more effective tool than the bodily physical focus most frequently used today.

Place, publisher, year, edition, pages
2007. Vol. 44, no 8, 1379-1390 p.
Keyword [en]
Chronic illness, Musculoskeletal problems, Nurses, Occupational health, Qualitative research
National Category
Environmental Health and Occupational Health
Identifiers
URN: urn:nbn:se:hig:diva-2740DOI: 10.1016/j.ijnurstu.2006.07.009ISI: 000250591100012PubMedID: 16973167Scopus ID: 2-s2.0-34548864113OAI: oai:DiVA.org:hig-2740DiVA: diva2:119402
Available from: 2008-05-19 Created: 2008-05-19 Last updated: 2016-10-28Bibliographically 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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