Designing for learning and knowing: Nurses in chronic care and patients' self-monitoring data

Abstract

This thesis focuses on nurses’ work practice in chronic care and their learning and knowing in relation to their patients’ self-monitoring data. It is anticipated that self-monitoring data used as a support for healthcare professionals’ work will help to overcome the current challenges the healthcare system is facing. Because of the way nurses’ work builds on learning and knowing in relation to data produced by patients, they will be expected to be able to use this kind of data when delivering care to the patients. However, we need to learn about what happens when a self-monitoring tool is developed and implemented in chronic care nurses’ work practice. The aim of this thesis was, therefore, to specifically investigate the nurses’ learning and knowing when they have access to the patients’ self-monitoring data. These issues were explored using a design ethnographic approach in a pelvic cancer rehabilitation clinic. Study I found that the nurses in chronic care intertwine the patients’ lived experience with the nurses’ medical knowledge and clinical experience to support the patients’ learning about their disease. Study II found that nurses manage the complexity of qualitative phenomena and mobile application features as a way to participate in a design process of a self-monitoring tool. Study III revealed the changes that occur in nurses’ work practice when they gain access to their patients’ self-monitoring data. Finally, the following themes across these studies were identified. First, mutual learning points to the different levels of learning that the nurses need to cope with. Second, the translation work of nurses builds on creating connections among the patients’ lived experiences, what the nurses are able to do, and the self-monitoring tools.