title: Conceptual development of "at-homeness" despite illness and disease: a review.
abstract: Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness." The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness" was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness" are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.
authors.affiliation: Palliative Research Centre, Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden; Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden; joakim.ohlen@esh.se.
authors.forename: Joakim
authors.initials: J
authors.lastname: Ohlén
authors.affiliation: Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care, Gothenburg, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Ekman
authors.affiliation: Research and Development Unit, Norrbotten County Council, Luleå, Sweden; Department of Health Sciences, Luleå University of Technology, Luleå, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Zingmark
authors.affiliation: Department of Care Science, Malmö University, Malmö, Sweden.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Bolmsjö
authors.affiliation: Department of Health and Caring Sciences, Linnæus University, Kalmar, Sweden; Center for Collaborative Palliative Care, Linnæus University, Kalmar, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Benzein
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology*; D003210:Concept Formation / Q000502:physiology*; D006801:Humans; D015399:Nursing Research / Q000379:methods; D013548:Sweden
keywords: At-homeness; concept development; home; literature review; well-being; wellness