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Posts tagged ‘Tiny Jaarsma’

An Exemplar of Middle-Range Theory Revision: Self-Care of Chronic Illness

The current featured ANS article is an open access article, which means it is permanently available for all readers.  The article is titled “Integrating Symptoms Into the Middle-Range Theory of Self-Care of Chronic Illness” authored by Barbara Riegel, PhD, RN, FAAN; Tiny Jaarsma, PhD, RN, FAAN; Christopher S. Lee, PhD, RN, FAAN; and Anna Stromberg, PhD, RN, FAAN. Their article provides insight into this specific middle-range theory, but also serves as an exemplar of theory development and revision. We are eager to know your comments and responses to their work!  Here is a message from Dr. Riegel about their work:

Barbara Riegel

The purpose of our theoretical refinement was to disambiguate relationships between symptoms and the behaviors of self-care maintenance, monitoring and management within Middle-Range Theory of Self-Care of Chronic Illness. Since the Middle-Range theory was first published in 2012, our group has received a lot of positive feedback and the theory has been used extensively. We also have had external requests from investigators and even federal institutions about how to harmonize insights from theories focused on self-care with those focused on symptoms. Moreover, and as part of the theory-data process of theoretical refinement, we also had internal motivation to provide clarity on aspects of the theory related to symptoms.

Salient new themes explicated in this theoretical revision include that symptoms can be viewed as being part of self-care (e.g. the appraisal, detection and interpretation of bodily

Tiny Jaarsma

changes as symptoms are essential to self-care monitoring), as barriers or facilitators of self-care (e.g. motivate or blunt self-care behaviors), as outcomes of self-care (e.g. optimal symptom control), or in interaction with self-care of (e.g. moderation) depending on the research question being posed. Further, the interpretation of bodily changes as symptoms is complex and prone to heterogeneity such that multiple clinical phenotypes likely exist in how patients can engage in self-care monitoring and management.

We learned a great deal from one another and from the work of several other self-care and symptom scientists in this process, and are excited to see how the revised theory will be used to help guide innovative research. Please follow us at:


Christopher S. Lee

Anna Stromberg

From the Authors: Riegel, Jaarsma & Strömberg

This message inaugurates our new blog feature – messages from the authors of our “Editor’s Picks” articles.  Here is a message from Barbara Riegel, Tiny Jaarsma, Anna Strömberg, authors of the featured article “Middle-Range Theory of self-care of chronic illness”

We are delighted to learn that our article is an Editor’s Pick of the current issue of ANS and provided for free to readers. The preparation of this article is the product of 3 years of collaboration during the time when Barbara Riegel was a Guest Professor at Linköping University in Sweden with Professors Tiny Jaarsma and Anna Strömberg. We brought to this collaboration years of individual research in the area of self-care and a growing recognition that comorbid illness complicates self-care for patients. We realized that  if patients and clinicians could be helped to see similarities in the self-care performed for various diagnoses, they might manage their self-care responsibilities  with more ease. Writing this article helped us integrate our prior research in self-care, our efforts to devise methods of measurement for self-care, and our devotion to teaching the next generation of scientists.

Currently, Anna Strömberg is leading a team primarily made up of faculty from Linköping University writing an article in which the theory is applied to a variety of chronic illnesses. As a team, we are teaching a graduate course on self-care of chronic illness at Linköping University. We have plans to develop a family of instruments that can be used to measure patients’ self-reports of self-care. These efforts should keep us busy for the years ahead.

Tiny Jaarsma, Anna Strömberg, Barbara Riegel,

Tiny Jaarsma, Anna Strömberg & Barbara Riegel

“Editor’s Picks” available now!

We have added a new feature to the ANS web site … Editor’s Picks from the current issue.  The Editor’s Picks will change every couple of weeks, and while an article is featured, it will be available for a free download!  Each week I will post information on this blog about one of the articles on the current “Editor’s Picks” list, giving some background and information about the article that I believe makes the article important for our readers.

Barbara Reigel (University of Pennsylvania), with her colleagues from Sweden Tiny Jaarsma and Anna Strömberg (Linköping University) are the authors of one of our first features, titled “A Middle-Range Theory of Self-Care of Chronic Illness.”  The theory was developed from self-care studies that the authors have conducted in several countries around the world; the article cites the studies so that you can trace the specific evidence on which the theory is based.

The authors address a central concern of nursing practice – the nature of the relationship between a nurse and a patient.  They explain the connection between that relationship and self-care of chronic illness as follows:   “When providers interact with patients their intention is that the partnership they form will motivate patients to engage in self-care that can be incorporated into their lifestyle. It is within this context of a mutually rewarding relationship that the self-care of chronic illness takes place.”

This theory was developed from sound research evidence, and in turn it provides an important resource to guide nursing practice.  It is based on deep analysis and clarification of some of the most persistent challenges that nurses face in building relationships with people living with chronic illness. This article  is an exemplar of one approach to the development of nursing theory that serves to guide nursing practice.

Check out the article now and add your ideas and thoughts about this article by replying to this post!  I look forward to hearing from you!

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