Meaningful coherence: Severe illness in the face of life and health care service. A single case-study

Abstract

Purpose: This article aims to investigate how a severely ill patient experiences health and disease, and which knowledge gains validity in the face of life and the public health care system. Method: The study is designed as a single case study. The empirical material is a text written by Geir Hellemo, published as personal experiences in the Journal for the Norwegian Medical Association. The analysis is thematic and is theoretically framed by Antonovsky’s theory on salutogenesis and the model for knowledge-based practice. Findings: Hellemo experience becoming severely ill and living with progressive disease as a burden when faced with the health care services. Considering knowledge-based practice and Antonovsky’s theory on salutogenesis, the interactions with the health care services seemingly are primarily characterized by a research-based and pathogenetic focus. Through life experiences and in meetings with some health care professionals, he has good bodily experiences and accordingly motivation for life with severe diseases. Creating an arena for coping and a sense of coherence. Conclusion: As a patient with severe illness a unilateral weighting of research-based knowledge is experienced as a contribution to an unfortunate focus on the disease. This illustrates how physiotherapists (and health care professionals) meeting severely ill patients can benefit from focusing on coping and motivation. The case study illustrates a need to include user-based knowledge and complicity, as well as experience-based knowledge in treatment.

Keywords

• severe illness
• antonovsky's salutogenesis
• knowledge based practice
• clinical physiotherapy