Table 4.
Second‐order interpretations | Evidence in the paper | Evidence in the paper | Evidence in the paper | Evidence in the paper | Evidence in the paper | Evidence in the paper | Evidence in the paper | Evidence in the paper |
---|---|---|---|---|---|---|---|---|
Paper 1 Slevin et al. 33 | Paper 2 Sheridan et al. 34 | Paper 3 Apps et al. 35 | Paper 4 Fotokion et al. 36 | Paper 5 Franklin et al. 37 | Paper 6 Zeb et al. 38 | Paper 7 Glenister et al. 39 | Paper 8 Willard‐Grace et al. 40 | |
Balancing social network participation with self‐care accountability and personal responsibility | Digital health technology (DHT) fosters self‐efficacy and independence. Increases confidence in completing SMS tasks associated with COPD | Helplessness undermines a personal ability to engage in SM | People with COPD reported being unsure of what constitutes an SM activity | Independence seeking; older people with COPD seek to reduce dependencies on others | An assumed responsibility and accountability for making the right care or treatment choices | People balance self‐care with finances and family. Often accountable for their care, but choosing to put family first | Understanding the experiences of COPD and social connectedness in a rural context | Managing illness and changing health behaviours can be internalized |
Often leading to devising personal management strategies | Challenging to discuss with professionals | |||||||
The value of positive engagements with healthcare professionals where socially supported self‐care is relevant | DHT promotes an equal discussion with health professionals. DHT records evidence of symptoms and supports articulation of symptoms in consultations | Frustration over conflicting information from health professionals (issues with negative consultations) | HP can support people with COPD to gain the maximum benefit from their SM endeavours | People engage in care processes only with trusted healthcare providers | People reported that generic education was not relatable. People wanted strategies to apply knowledge to individual situations | Access to formal care provision is at a cost. Relationships are with informal healthcare providers and lay healers | Positive relationships and open, candid conversations were valued with local rural healthcare professionals | Lay coaching bridges this relationship. Aids service negotiation and honest conversations |
People would value recognition of personal health status, mood and issues | ‘Unheard’ patients reduced SM | |||||||
Developing a personal understanding of illness through social participation and shared and personal experiences | DHT prompts personal proactive responses to symptom changes | Decisions shaped by experiences of failure in SM | Strength loss and fatigue not associated with COPD | External information‐seeking through peers. This information was deemed more accessible | People reported having poor understanding of what constituted healthy and unhealthy choices | The family, spirituality and community are highly valued. Some health beliefs are culturally nuanced, such as the belief that disease is a curse from god | Learning to cope with and balance social life and adapt to new illness symptoms, learning when to seek help and link with others | Lay explanations of disease and support with aspects of a person's life that they value the most |
COPD confused with asthma, so misleading illness trajectories | Trial and error adaptations to daily living were most acceptable | Knowing that is derived from experiential constructs | ||||||
Recognizing the importance of social networks to guide and validate personal choices in people with COPD | Reassurance of support through online/offline feedback | God, church and the family valued above all other things | Poor social networks lead to frustration, unable to link with others. Positive networks foster discussions to adapt tasks and SM with other network members | Familial groups can empower people by providing communication channels to the outside world | The behaviours and choices of people with COPD were shaped by a broader social context | Self‐care is encouraged and delivered by the extended family, including emotional and social needs. It is a selfless act, valued and encouraged | Learning when to seek help, from the community through a community infrastructure | Focus on psychosocial needs, housing and environment |
Although not a person, people valued discussion around their condition | Social isolation adds to the emotional burden | Relational aspects of care most valued | ||||||
Cultural value of social networks, people living alone struggled with SM |
Abbreviation: COPD, chronic obstructive pulmonary disease.