Public defence in caring science: Susanna Strandberg
Thesis title:
Co-creating self-care – Experiences of self-care and usage of eHealth among older adults with chronic illness, informal carers, and healthcare professionals
Third-cycle subject area:
Caring science
Faculty:
Faculty of Health and Life Sciences
Date:
Friday 4 April 2025 at 10:00
Place for thesis:
Room Weber, Building K, Växjö and via Zoom
External reviewer:
Professor Christine Gustafsson, Sophiahemmet University and affiliated with Mälardalen University
Examining committee:
Professor Anna Strömberg, Linköping University
Docent Sofie Fristedt, Jönköping University
Professor Stefan Lagrosen, Department of Management, Linnaeus University
Chairperson:
Docent Jalal Safipour, Department of Health and Caring Sciences, Linnaeus University
Supervisor:
Professor Mirjam Ekstedt, Department of Health and Caring Sciences, Linnaeus University
Assistant supervisor:
Professor Cecilia Fagerström, Department of Health and Caring Sciences, Linnaeus University and Docent Sofia Backåberg, Department of Health and Caring Sciences, Linnaeus University
Examiner:
Docent Jalal Safipour, Department of Health and Caring Sciences, Linnaeus University
Spikning:
Friday 14 March 2025 at 10:00 at University Library, Växjö
In order to receive the Zoom link for the thesis defense, please contact Faculty Administrator Mirjam Lingkrans: mirjam.lingkrans@lnu.se
Abstract
Aim: To explore the co-creation of self-care and the use of eHealth among older adults with chronic illness, their informal carers, and healthcare professionals.
Methods: This thesis employed various qualitative methods across four studies. Study I aimed to clarify the concept of “self-care monitoring” from a patient perspective through a concept analysis based on a systematic search of peer-reviewed articles from four databases. Study II aimed to describe patients’ and informal carers’ experiences of self-care management and the use of telemonitoring applications, using semi-structured telephone interviews analyzed by qualitative content analysis. Study III aimed to co-create and test a video feedback tool for self-care at home, using an experience-based co-design approach that facilitated collaboration between pairs of older adults, researchers, and service designers through three iterative steps: workshops, development and refinement, and usability testing. Data were analyzed using thematic analysis, applying both inductive and deductive approaches. Study IV aimed to describe healthcare professionals’ experiences on motivating self-care, utilizing individual narrative interviews analyzed by a phenomenological-hermeneutic approach.
Results: Study I clarified the concept of “self-care monitoring”, resulting in the definition: “Self-care monitoring is an activity requiring a person to be aware, confident, and have a routine when following symptoms, signs, and actions.” Study II described self-care management with telemonitoring at home, captured in the theme “Developing the capability to perform self-care with technology as both an intruder and an invited guest.” Telemonitoring supported skill acquisition and engagement with healthcare professionals but also introduced uncertainties in symptom interpretation and exclusion. Study III co-created and tested two new self-care exercises within the video feedback tool: “Breathing exercises” and “Picking up from the floor.” Older adults found the exercises and feedback valuable for learning, particularly in highlighting movement variability through performance comparison. Study IV described healthcare professionals’ experiences of motivating self-care, revealing “Co-creating sustainable self-care responsibilities” as the main theme, encompassing empowerment through mutuality, reassigning responsibility, and using oneself as a creative tool.
Conclusion: This thesis highlights co-created self-care as a dynamic, empowering process shaped by collaboration, shared responsibility, and active engagement among older adults with chronic illness, informal carers, and healthcare professionals. Engagement in self-care strengthens through interactive approaches like peer support, video feedback, and telemonitoring, enhancing motivation, confidence, and adherence. Future research should focus on long-term engagement strategies and integrating eHealth into primary care to improve co-created self-care.
Keywords: chronic illness, co-creation, eHealth, experiences, healthcare professionals, informal carer, older adults, peer support, primary care, qualitative, self-care