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  • 1.
    Biguet, Gabriele
    et al.
    Department of Neurobiology, Care Sciences and Society, division of Physiotherapy, Karolinska institutet.
    Nilsson Wikmar, Lena
    Department of Neurobiology, Caring Sciences and Society, Division of Physiotherapy, Karoliniska Institutet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Flink, Berit
    Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet.
    Löfgren, Monika
    Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet.
    Meanings of "acceptance" for patients with long-term pain when starting rehabilitation2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 13, p. 1257-1267Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The study aimed to elucidate the meaning of acceptance in relation to the lived body and sense of self when entering a pain rehabilitation programme.

    METHODS: Six women and three men with long-term pain were interviewed. The interviews were analysed according to interpretative phenomenological analysis.

    RESULTS: The analysis revealed three different meaning structures, first: acceptance as a process of personal empowerment, "the only way forward". Here, the individuals expressed that the body felt integrated: a trusting cooperation between self and body gave rise to hope. Second: acceptance as an equivocal project, a possible but challenging way forward. The hopeful insight was there, acknowledging that acceptance was the way to move forward, but there was also uncertainty and doubt about one's ability with a body ambiguous and confusing, difficult but important to understand. Third, in acceptance as a threat and a personal failure, "no way forward" the integration of the aching body in sense of self was impossible and pain was incomprehensible, unacceptable and unfair. Pain was the cause of feeling stuck in the body, affecting the sense of self and the person's entire life.

    CONCLUSIONS: The meaning of acceptance was related to acceptance of the persistency of pain, to how the individual related to the lived body and the need for changes in core aspects of self, and to the issue of whether to include others in the struggle of learning to move on with a meaningful life. Implications for Rehabilitation Healthcare professionals should be aware that individuals with long-term pain conceptualize and hold different meanings of acceptance when starting rehabilitation; this should be considered and addressed in rehabilitation programmes. The meaning given to acceptance is related to the experience of the lived body and the sense of self, as well as to getting legitimization/acceptance by others; therefore these aspects need to be considered during rehabilitation. The process of achieving acceptance seems to embrace different processes which can be understood as, and facilitated by, an embodied learning process. The bodily existential challenges presented in the present study, for example to develop an integrated and cooperative relationship with the painful body, can inspire health professionals to develop interventions and communication strategies focusing on the lived body. A wide range of competencies in rehabilitation clinics seems to be needed.

  • 2. Bragee, B
    et al.
    Bullington, Jennifer
    Linköpings universitet.
    From health to disease: a New Approach to Study the Emergence of Psychosomatic Symptoms2003In: Psychotherapy and Psychosomatics, ISSN 0033-3190, E-ISSN 1423-0348, Vol. 72, no 4, p. 228-229Article in journal (Refereed)
  • 3.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Att vara kropp: värdigheten som mänskligt förkroppsligande2010In: Värdighet i vården av äldre personer / [ed] Lennart Nordenfelt, Lund: Studentlitteratur AB , 2010, 1, p. 105-137Chapter in book (Other academic)
  • 4.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Being body: the dignity of human embodiment2009In: Dignity in care for older people / [ed] Lennart Nordenfelt, Chichester, U.K.: Wiley-Blackwell , 2009, p. 54-76Chapter in book (Other academic)
  • 5.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Body and self: a phenomenological study on the ageing body and identity2006In: Journal of Medical Humanities, ISSN 1041-3545, E-ISSN 1573-3645, Vol. 32, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate how older people (60+) experience the ageing body and how these experiences affect aged peoples’ sense of identity. Explorative, open ended, interviews were conducted with 13 respondents between the ages of 63 and 82, recruited from a retired peoples’ organisation, Church organisations, and from the working population. The qualitative data was analysed with a phenomenological method, the so called EPP method, the empirical phenomenological psychological method. The results showed that generally the experience of the ageing body has to do with a changed life world, reactions to this change in terms of body and self, and finding ways to feel at home in this changed situation. Results are presented as three typologies, reflecting the different ways in which the respondents described this general experience: existential awakening, making it good enough, and new possibilities. The results give support to the research that points out the importance of activity for the self esteem of the elderly. According to this study, however, the meaning of “activity” can vary and can have different sources of motivation. Respondents in only one typology expressed frustration over limitations of the ageing body. Respondents exhibited entirely different ways of relating to the fact that death was approaching, which raises questions about how the elderly experience this impending horizon. Finally, the gender differences in this small study were quite clear: all the male respondents belonged to the typology “New possibilities”, raising questions about gender aspects concerning the meaning of freedom, appearance, activity, and self esteem.

  • 6.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Body and Self: a phenomenological study on the aging body and identity2006In: The Self in Health and Illness: Patients, Professionals and Narrative Identity / [ed] Frances Rapport,Paul Wainwright, Oxford: Radcliffe Publishing , 2006, p. 69-82Chapter in book (Other academic)
  • 7.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Den objektiva kroppen och den levda kroppen i behandlingsrummet2004In: När människan möter medicinen: livsvärldens och berättelsens betydelse för förståelsen av sjukdom och medicinsk teknologi / [ed] Sonja Olin Lauritzen, Fredrik Svenaeus & Ann-Christine Jonsson, Stockholm: Carlsson , 2004, p. 49-68Chapter in book (Other academic)
  • 8.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Embodiment and chronic pain: implications for rehabilitation practice2009In: Health Care Analysis, ISSN 1065-3058, E-ISSN 1573-3394, Vol. 17, no 2, p. 100-109Article in journal (Refereed)
    Abstract [en]

    Throughout the Western world people turn towards the health care system seeking help for a variety of psychosomatic/psychosocial health problems. They become "patients" and find themselves within a system of practises that conceptualizes their bodies as "objective" bodies, treats their ill health in terms of the malfunctioning machine, and compartmentalizes their lived experiences into medically interpreted symptoms and signs of underlying biological dysfunction. The aim of this article is to present an alternative way of describing ill health and rehabilitation using the philosophy of Maurice Merleau-Ponty in order to deepen our understanding of the rehabilitation process. I will explore how the experience of chronic pain ruptures the natural connection between body and world and how the rehabilitation process can be understood as the re-insertion of the body into the flow of experience, where the body "disappears" into its natural silence in order to allow the world to once again unfold. The experience of chronic pain places the painful body in focus, resulting in a diminished articulation of both self and world. Persons with illness suffer not only from the physical aspects of pain and discomfort but also from a loss of identity where one feels alienated and detached from things that used to give meaning to ones life. Rehabilitation must not only address the material (medical) body but also the diminished sense of self as well as the retreat from the world outside of the painful body.

  • 9.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    En "alternativ" syn på kroppen, inspirerad av Merleau-Pontys filosofi2004In: Perspektiv på komplementär medicin: medicinsk pluralism i mångvetenskaplig belysning / [ed] Motzi Eklöf, Lund: Studentlitteratur , 2004, p. 101-115Chapter in book (Other academic)
  • 10.
    Bullington, Jennifer
    Linköpings universitet.
    Health and receptivity: a phenomenological interpretation of allostasis2003In: Dimensions of health and health promotion / [ed] Lennart Nordenfelt, Per-Erik Liss, Amsterdam: Rodopi , 2003, p. 83-95Chapter in book (Other academic)
  • 11.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hälsa ur ett psykosomatiskt perspektiv2011In: Perspektiv på kvinnors hälsa i arbetslivet / [ed] Hélène Sandmark, Lund: Studentlitteratur, 2011, p. 65-84Chapter in book (Other academic)
  • 12.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Kropp, själ och meningsskapande2008In: Omsorg: Nordisk tidsskrift for Palliativ Medisin, ISSN 0800-7489, no 2, p. 9-12Article in journal (Other academic)
  • 13.
    Bullington, Jennifer
    Karolinska institutet.
    Psykosomatik: en biomedicinsk anomali - hur ska vi förstå det psykosomatiska?2001In: Filosofisk tidskrift, ISSN 0348-7482, no 4Article in journal (Other academic)
  • 14.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Psykosomatik och meningsskapande: En tillämpning av Maurice Merleau-Pontys fenomenologi2012In: Att förstå kroppens budskap: sjukgymnastiska perspektiv / [ed] Gabriele Biguet, Riitta Keskinen-Rosenqvist, Adrienne Levy Berg, Lund: Studentlitteratur , 2012, 1Chapter in book (Other academic)
  • 15.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Psykosomatik: om kropp, själ och meningsskapande2007 (ed. 1)Book (Other academic)
  • 16.
    Bullington, Jennifer
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Samtalskonst i vården: Samtalsträning för sjuksköterskor på fenomenologisk grund2018Book (Refereed)
  • 17.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    The Expression of the Psychosomatic Body from a Phenomenological Perspective2013Book (Other academic)
  • 18.
    Bullington, Jennifer
    Linköpings universitet.
    The mysterious life of the body: a new look at psychosomatics1999Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of this study is to critically examine traditional psychosomatic theories, paying special attention to certain philosophical issues such as the mind-body problem and efficacious mechanisms of interaction between meaning, understood as psychosocial factors, and that which is traditionally called "body" (the material, objectified body). Afterwards, an alternative psychosomatic theory is worked out, drawing inspiration from the phenomenology of Maurice Merleau-Ponty. The first part of the dissertation examines the following schools of thought (orientations) concerning psychosomatic theory: 1) psychodynamic theory, 2) psychosomatic medicine, 3) stress theory as well as neuroimmunology and neuroendocrinology, and 4) the work of the psychobiologist Herbert Weiner. The phenomenological alternative worked out in part II of the dissertation breaks up dualistic and materialistic-reductionistic thinking by starting with the "lived body" rather than the objective body studied by natural science. The question then becomes, how is the mind-body unity lived, and what categories of understanding open up when the person-world field becomes the focus for psychosomatic theory.

  • 19.
    Bullington, Jennifer
    Linköpings universitet.
    The mysterious life of the body: a new look at psychosomatics1999Book (Other academic)
  • 20.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Vad är det som läker?: existentiella aspekter på hälsa och sjukdom2010In: " Visst längtar jag fortfarande efter något...": om etik och andlighet i vård, psykoterapi och musik / [ed] Gunilla Silfverberg, Stockholm: Ersta Sköndal högskola , 2010, p. 47-66Chapter in book (Other academic)
  • 21.
    Bullington, Jennifer
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: A pilot intervention study2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes.

    AIM: The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatichealth issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention?

    METHODS: The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention.

    FINDINGS:The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed.

    IMPLICATIONS: This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based supervision intervention.

  • 22.
    Bullington, Jennifer
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    The fuzzy concept of 'holistic care': a critical examination2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 3, p. 493-494Article in journal (Refereed)
  • 23.
    Bullington, Jennifer
    et al.
    Linköpings universitet.
    Karlsson, G
    Hur uppfattar en blind person sin kropp?1998In: Social forskning, ISSN 0283-202X, Vol. 13, p. 8-10Article in journal (Refereed)
  • 24.
    Bullington, Jennifer
    et al.
    Linköpings universitet.
    Karlsson, G
    Några reflektioner över barndomsblindas kroppsupplevelse1999In: Leva som blind: fenomenologisk-psykologiska undersökningar / [ed] Gunnar Karlsson (förf.), Stockholm: Carlsson , 1999, p. 61-81Chapter in book (Other academic)
  • 25.
    Bullington, Jennifer
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nordemar, Rolf
    Haegerstam, Glenn
    Evidensbaserad medicin räcker inte2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 11, p. 797-798Article in journal (Other academic)
  • 26.
    Bullington, Jennifer
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nordemar, Rolf
    S:t Görans sjukhus, Stockholm, Karolinska institutet.
    Nordemar, Kristina
    S:t Görans sjukhus, Stockholm.
    Sjöström-Flanagan, Charlotte
    S:t Görans sjukhus, Stockholm.
    Meaning out of chaos: a way to understand chronic pain2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 4, p. 325-331Article in journal (Refereed)
    Abstract [en]

    Pain is a multidimensional phenomenon lying at the intersection between biology and culture. The modern understanding of pain takes into account emotional, psychological, socio-political and existential aspects of pain as well as physiological, anatomical factors. Our aim in this study was to deepen the understanding of psychosocial, existential aspects of pain and to discuss how clinicians can better understand and treat patients with chronic pain. A focus group was formed consisting of a researcher and a group of clinicians (n = 3) with various backgrounds working at a specialized pain clinic. The group met once a month during a 6-month period. Questions concerning the life-world of the pain patient as well as inquiries into the conditions for 'the good clinical encounter' were investigated. The results of this study consist of a systematization of the data (focus group meetings) collected and analysed in a collaborative effort between the researcher and group participants. The findings are presented in terms of themes. The main metaphor used to describe the path from the seeking of medical help to successful rehabilitation was order out of chaos. Ordering chaos was a process moving from diagnosis through a phase of heightened self-awareness towards responsibility-taking on the part of the patient. Related themes presented, illustrated and discussed in the paper concern problems of linkage, the role of flexibility and creativity in the healing process and the kind of clinical encounter conducive for the journey from chaos to the creation of new meaning.

  • 27.
    Bullington, Jennifer
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sjöström-Flanagan, Charlotte
    Vietnam.
    Nordemar, Kristina
    St Görans sjukhus, Stockholm.
    Nordemar, Rolf
    S:t Görans sjukhus, Stockholm, Karolinsta institutet.
    From pain through chaos towards new meaning: Two case studies2005In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 32, no 4, p. 261-274Article in journal (Refereed)
  • 28.
    Carballeira Suarez, Nivia
    et al.
    Umeå Universitet.
    Levi, Richard
    Umeå Universitet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Regaining health and wellbeing after traumatic spinal cord injury2013In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, no 10, p. 1023-1027Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Traumatic spinal cord injury is typically a devastating event, leading to permanent physical disability. Despite the severity of the condition, many persons with traumatic spinal cord injury manage to lead both active and independent lives. The aim of this study was to investigate the experience of health and wellbeing of persons living with a traumatic spinal cord injury for at least 20 years. Design and methods: A qualitative design was used. Data was analysed using a phenomenological-hermeneutical method. Rich narratives were obtained from 14 persons with paraplegia due to traumatic spinal cord injury sustained at least 20 years ago. RESULTS: The key finding was that health and wellbeing were attained when persons were able to perceive themselves as being “normal” in everyday relationships and circumstances. The normalization process involved learning to negotiate and/or prevent potentially embarrassing situations by acting in a “parallel world”, covertly “behind the scenes”. CONCLUSION: The subjective experience of wellbeing and health after traumatic spinal cord injury depends upon the ability to prevent or resolve potentially embarrassing situations without this being noticed by others. Performing this work “behind the scenes”, enables persons with traumatic spinal cord injury to interact smoothly with others and thereby be perceived as normal, despite substantial disability.

  • 29.
    Gutke, Annelie
    et al.
    Göteborgs universitet.
    Bullington, Jennifer
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Lund, Madeleine
    Göteborgs stad.
    Lundberg, Mari
    Karolinska Institutet; Sahlgrenska Universitetssjukhuset.
    Adaptation to a changed body: Experiences of living with long-term pelvic girdle pain after childbirth2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 25, p. 3054-3060Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore how women experience living with long-term pregnancy-related pelvic girdle pain.

    Materials and methods: Nine women with persistent pregnancy-related pelvic girdle pain of 2–13 years were recruited by means of purposive sampling from long-term follow-up studies. The women were 28–42 years of age and had given birth to 2–3 children. Audio-taped in-depth interview with open-ended questions were used with the guiding question 'How do you experience living with pregnancy-related pelvic girdle pain?'. The Empirical Phenomenological Psychological method was chosen for analysis.

    Results: The pregnancy-related pelvic girdle pain syndrome has a profound impact on everyday life for many years after pregnancy. Three constituents were identified as central to the experience of living with pregnancy-related pelvic girdle pain: (1) the importance of the body for identity, (2) the understanding of pain, and (3) stages of change. The manner in which the women experienced their pain was interpreted in terms of two typologies: the ongoing struggle against the pain, and adaptation and acceptance.

    Conclusion: The participants’ narratives highlighted that the pain led to severe functional limitations that threatened their capability to perform meaningful daily activities, and interfered with their sense of identity. It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.

    IMPLICATIONS FOR REHABILITATION

    Chronic pregnancy-related pelvic girdle pain

    • Pregnancy-related pelvic girdle pain impairs women’s capacity to perform meaningful activities of daily life for many years after pregnancy.
    • The participants’ narratives highlighted that the pain interfered with their sense of identity.
    • It appears essential to meet with each patient individually and to manage long-term pregnancy-related pelvic girdle pain as a pain syndrome.
  • 30. Hellström, Olle
    et al.
    Bullington, Jennifer
    Linköpings universitet.
    Karlsson, Gunnar
    Lindqvist, Per
    Mattsson, Bengt
    A phenomenological study of fibromyalgia: patient perspectives1999In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 17, no 1, p. 11-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the way in which the fibromyalgia patients understand the meaning of their illness. DESIGN: Qualitative, empirical phenomenological psychological method. SETTING: A collaborative transdisciplinary interview study of patients' described experiences of living with fibromyalgia. No therapeutic relationships existed between patients and researchers. SUBJECTS: Eighteen patients with fibromyalgia were interviewed. Ten of the 18 taped interviews were transcribed and analysed. MAIN OUTCOME MEASURES: Patients' narratives, described experiences of living with fibromyalgia. RESULTS: The patients were intensively involved in efforts to get their self-images as ill persons confirmed. Their experience was that the disease started dramatically, with a variety of capriciously appearing symptoms of unknown cause that gave rise to the suffering. The fibromyalgia patients seemed to develop strategies to cope with a precarious self-image and find ways to manage the thought of what the future would bring. CONCLUSION: The meaning structures revealed in the patients' ways of describing their experiences of living with fibromyalgia seemed to be partially constituted by their efforts to stand forth as afflicted with a disease, which could be a way to help them to manage the demands that they placed upon themselves.

  • 31. Hellström, Olle
    et al.
    Bullington, Jennifer
    Linköpings universitet.
    Karlsson, Gunnar
    Lindqvist, Per
    Mattsson, Bengt
    Doctors' attitudes to fibromyalgia: a phenomenological study1998In: Scandinavian journal of social medicine, ISSN 0300-8037, Vol. 26, no 3, p. 232-237Article in journal (Refereed)
    Abstract [en]

    Besides specific technical skills, successful encounters with patients require an understanding of the many ways in which patients may express themselves. This qualitative study reports on the clinical experiences of doctors when meeting patients with fibromyalgia (FM). Ten strategically chosen rheumatologists and 10 GPs in central Sweden were interviewed. The interviews were taped, transcribed and analysed in accordance with the empirical, phenomenological, psychological method. The analyses indicate that doctors try to comply with the wishes and demands of patients, and at the same time avoid perceptions of personal frustration. They are inclined to be objective and to act instrumentally, apparently in order to keep in touch with what gave biomedical meaning to an otherwise incomprehensible phenomenon. The meaning structures revealed by doctors' descriptions of FM and of relating to FM patients were characterized mainly by the way in which the doctors were (i) managing their clinical uncertainty, (ii) adhering to the biomedical paradigm, (iii) prioritizing diagnostics, (iv) establishing an instrumental relationship, and (v) avoiding recognizing FM as a possible biomedical anomaly.

  • 32.
    Levy Berg, Adrienne
    et al.
    Karolinska institutet.
    Sandahl, Christer
    Karolinska institutet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Patients perspective of change processes in affect-focused body psychotherapy for generalized anxiety disorder2010In: Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice, ISSN 1743-2979, E-ISSN 1743-2987, Vol. 5, no 2, p. 151-169Article in journal (Refereed)
  • 33.
    Lundberg, Mari
    et al.
    Göteborgs universitet.
    Hagberg, Kerstin
    Göteborgs universitet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    My prosthesis as part of me: qualitative analysis of living with an osseointegrated prosthetic limb2011In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 35, no 2, p. 207-214Article in journal (Refereed)
    Abstract [en]

    Background:Bone-anchored prosthesis is still a rather unusual treatment for patients with limb loss.

    Objectives: The aim of this study was to improve our understanding about the experience of living with an osseointegrated prosthesis (OI-prosthesis) compared to one suspended with a socket, through the use of qualitative research methodology.

    Study design: A qualitative phenomenological research method.

    Methods: Thirteen Swedish patients (37–67 years) with unilateral upper or lower limb amputation (10 transfemoral, 2 transhumeral, 1 transradial), who had been using OI-prostheses for 3 to 15 years, were recruited by means of purposive sampling. An audio-taped in-depth interview was performed. The guiding question was ‘How do you experience living with your osseointegrated prosthesis compared to your earlier prostheses suspended with sockets?’. The empirical phenomenological psychological method was used for data analysis.

    Results: The results showed that all participants described living with an OI-prosthesis as a revolutionary change. These experiences were described in terms of three typologies, called ‘Practical prosthesis’, ‘Pretend limb’ and ‘A part of me’.

    Conclusions: The most important finding was that the change went beyond the functional improvements, integrating the existential implications in the concept of quality of life.

    Clinical relevance: This qualitative in-depth interview study on patients using bone-anchored prosthetic limbs showed that all described a revolutionary change in their lives as amputees and the meaning of that change went beyond the functional improvements, integrating existential implications in the concept of quality of life.

  • 34.
    Lundberg, Mari
    et al.
    Göteborgs universitet.
    Styf, Jorma
    Ersta Sköndal University College, Department of Health Care Sciences.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Experiences of moving with persistent pain: A qualitative study from a patient perspective2007In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 23, no 4, p. 199-209Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the present study was to use a phenomenological approach to explore how patients with persistent musculoskeletal pain experienced moving with their pain.

    Design: In-depth interviews were performed by a physical therapy researcher with many years' experience with the rehabilitation of patients with persistent musculoskeletal pain.

    Setting: The patients took part in individual rehabilitation at two different physical therapy departments. All but one patient opted to be interviewed in a room at the physical therapy department.

    Method: The sample was purposive and consisted of 10 Swedish outpatients with heterogeneous nonmalignant persistent musculoskeletal pain.

    Subjects: The interviews were analyzed according to a qualitative method known as the Empirical Phenomenological Psychological (EPP) method. The results were coded, analyzed, and described in typologies.

    Results: The experience of moving with pain implied much more than pure physical movement. Pain was a threatening challenge to the informants' existence and identity. Three typologies were identified: failed adaptation, identity restoration, and finding the way out.

    Conclusions: In conclusion, to move with persistent pain was described by the informants as having deep existential impact on the individual's life. It was also evident that all of the informants experienced a dramatic change in their identity. These experiences would most likely affect the patients' chances of recovery. To help him/her through the rehabilitation process, we need to extend our knowledge about what it means to the patient in an existential context to be unable to move as before.

  • 35.
    Lööf, Helena
    et al.
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Henriksson, Elisabeth
    Karolinska institutet.
    Lindblad, Staffan
    Karolinska institutet.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Body awareness in persons diagnosed with rheumatoid arthritis2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, article id 24670Article in journal (Refereed)
    Abstract [en]

    Living with rheumatoid arthritis (RA) poses physiological and psychological demands on a person. RA is a autoimmune disease that can cause pain, disability, and suffering. The ability to notice bodily inner sensations and stimuli (body awareness, BA) is described in the literature in ways that could have either a positive or a negative impact on a person's health. The concept of BA is complex and a thorough understanding is needed about what BA means from the patient's perspective. This study was therefore conducted to acquire greater insight into this phenomenon. The study is grounded in a phenomenological life-world perspective. Eighteen narrative interviews were conducted in patients (age range 23–78 years) with RA. The interviews were analyzed using the Empirical Phenomenological Psychological method. General characteristics were found running through all 18 interviews, indicating that the disease resulted in a higher degree of negatively toned BA. BA was either a reactive process of searching or controlling after disease-related symptoms or a reactive process triggered by emotions. BA was an active process of taking an inventory of abilities. All participants had the ability to shift focus from BA to the outside world. Four typologies were identified: “A reactive process on symptoms,” “A reactive process on emotional triggers,” “An active process of taking an inventory of abilities,” and “A shifting from BA to the outside world.” In conclusion, because BA can be both positively and negatively toned, health care professionals must have a good understanding of when BA is positive and when it is negative in relation to the patient. RA had caused a higher degree of negatively toned BA. Thus, the ability to shift attention from BA to activity in the outside world could sometimes be beneficial for the patient's general health.

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