Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach

Hjelm, Markus; Holmgren, Ann-Charlotte; Willman, Ania; Bohman, Doris; Holst, Göran

doi:10.5334/ijic.1538

Cited by 7 publications

(7 citation statements)

References 32 publications

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“…Our findings were similar to an early American survey where Malone Beach and colleagues (MaloneBeach et al, 1992) found caregivers' perceptions of case management to be an important aspect of the satisfaction of having a special relationship with a person who provided emotional care and navigated the caregivers through the system. A Swedish phenomenological study (Hjelm et al, 2015) found similar results when they explored the understanding of importance of case managers to family members of older persons. The sub-theme "Helps me feel secure -Experiencing a trusting relationship" deepened their understanding of relatives' perception of case managers as providing comfort and having good intentions in giving support (Hjelm et al, 2015).…”

Section: Discussionsupporting

confidence: 62%

“…A Swedish phenomenological study (Hjelm et al, 2015) found similar results when they explored the understanding of importance of case managers to family members of older persons. The sub-theme "Helps me feel secure -Experiencing a trusting relationship" deepened their understanding of relatives' perception of case managers as providing comfort and having good intentions in giving support (Hjelm et al, 2015). Feeling secure and having someone to turn to are considered important features of case management.…”

Section: Discussionsupporting

confidence: 62%

“…An evaluation of the effect of case management interventions can therefore be difficult due to lack of definition and content of case management and because the details of the case management interventions are seldom described (Sandberg et al, 2015). The complexity of case management implies the coordination of different services and the implementation of the comprehensive care elements in an integrated care trajectory (Hjelm et al, 2015). Case management is a complex intervention and therefore requires a mixed-method, stepwise evaluation to establish evidence (The Medical Research Council, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A sense of security: Spouses' experiences of participating in an orthopaedic case management intervention (the SICAM-trial)

Berthelsen

Kristensson

2017

International Journal of Orthopaedic and Trauma Nursing

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 62%

Section: Introductionmentioning

confidence: 99%

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A sense of security: Spouses' experiences of participating in an orthopaedic case management intervention (the SICAM-trial)

Berthelsen

Kristensson

2017

International Journal of Orthopaedic and Trauma Nursing

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“…It recognizes that our experiences are perceived and interpreted at an individual level [ 15 ], hence we felt it was an appropriate methodological approach for this study. IPA has been widely used within health care research to explore the experience of illness by patients and caregivers [ 16 , 17 ]. With increased emphasis on patient-reported experience measures and their recognized correlation with patient-reported outcomes [ 18 ], this methodological approach may gain further in popularity.…”

mentioning

confidence: 99%

Why do people choose nephrology? Identifying positive motivators to aid recruitment and retention

Beckwith

Kingsbury

Horsburgh

2018

Clinical Kidney Journal

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Increasing concerns about recruitment and retention of junior doctors have led to renewed interest in how and when trainees choose their specialties. To our knowledge, no study has yet reported what attracts UK applicants to nephrology nor how clinicians develop vocational interests or make occupational choices. With this in mind, we sought to explore the motivation behind current nephrologist’s career choices in the UK. We interviewed 11 nephrologists using a semi-structured face-to-face approach and used interpretative phenomenological analysis to conduct and analyse the interviews. We found role models were pivotal in encouraging specialization in nephrology, particularly those encountered in early postgraduate training. The diversity, diagnostic challenge and cross-specialty knowledge was highlighted as well as the ability to ‘make a difference to patients’ lives’. Nephrologists enjoyed the challenge of managing very sick, acutely unwell patients as well as the holistic continuity of long-term care offered to dialysis patients and their families. Academic and procedural components were attractive motivators to the specialty and the flexibility to have multiple interests was noted, with many nephrologists having ‘portfolio’ careers. Based on these results, we suggest strategies the specialty can use to aid policy decision making, promote recruitment and improve educational experiences within current training programmes.

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“…(3) Case management : Case managers are trained healthcare professionals who are the main contact (and conduit of information) between a patient and involved providers,53 and most appropriate for multimorbidity management when there may be multiple and diverse providers involved in a patient’s care. When case managers are the primary contact,80 103 care is perceived by patients as continuous,78 79 coordinated79 and more individualised,9 80 and fosters the development of the skills and confidence patients need to self-manage their health 78…”

Section: Resultsmentioning

confidence: 99%

Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review

et al. 2019

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ObjectivesTo understand how and why effective multi-chronic disease management interventions influence health outcomes in older adults 65 years of age or older.DesignA realist review.Data sourcesElectronic databases including Medline and Embase (inception to December 2017); and the grey literature.Eligibility criteria for selecting studiesWe considered any studies (ie, experimental quasi-experimental, observational, qualitative and mixed-methods studies) as long as they provided data to explain our programme theories and effectiveness review (published elsewhere) findings. The population of interest was older adults (age ≥65 years) with two or more chronic conditions.AnalysisWe used the Realist And MEta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication criteria for our synthesis aimed at refining our programme theories such that they contained multiple context-mechanism-outcome configurations describing the ways different mechanisms fire to generate outcomes. We created a 3-step synthesis process grounded in meta-ethnography to separate units of data from articles, and to derive explanatory statements across them.Results106 articles contributed to the analysis. We refined our programme theories to explain multimorbidity management in older adults: (1) care coordination interventions with the best potential for impact are team-based strategies, disease management programmes and case management; (2) optimised disease prioritisation involves ensuring that clinician work with patients to identify what symptoms are problematic and why, and to explore options that are acceptable to both clinicians and patients and (3) optimised patient self-management is dependent on patients’ capacity for selfcare and to what extent, and establishing what patients need to enable selfcare.ConclusionsTo optimise care, both clinical management and patient self-management need to be considered from multiple perspectives (patient, provider and system). To mitigate the complexities of multimorbidity management, patients focus on reducing symptoms and preserving quality of life while providers focus on the condition that most threaten morbidity and mortality.PROSPERO registration numberCRD42014014489.

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Family members of older persons with multi-morbidity and their experiences of case managers in Sweden: an interpretive phenomenological approach

Abstract: Background: Family members of older persons (75+) with multi-morbidity are likely to benefit from utilising case management services performed by case managers. However, research has not yet explored their experiences of case managers.

Cited by 7 publications

References 32 publications

A sense of security: Spouses' experiences of participating in an orthopaedic case management intervention (the SICAM-trial)

A sense of security: Spouses' experiences of participating in an orthopaedic case management intervention (the SICAM-trial)

Why do people choose nephrology? Identifying positive motivators to aid recruitment and retention

Underlying mechanisms of complex interventions addressing the care of older adults with multimorbidity: a realist review

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