Now What? Collective Sensemaking and Sensegiving in the Cystic Fibrosis Community in Sweden During the Initial Phase of the COVID-19 Pandemic

Figures & data

Table 1. Coding guide with definitions of the five primary macrocognitive functions and descriptions of what to look for in the data.

Macrocognitive function	Definition	What to look for in the data
Sensemaking	“Sensemaking can take several forms: expanding an existing account of a situation, questioning whether an existing account is accurate, explaining away inconsistent data, contrasting the merits of different accounts of the same data, replacing one account with another, and constructing a novel account” (Crandall et al., 2006, p. 138).	Meaning units reflecting how individuals try to make sense of the COVID-19 pandemic and anticipate how it will develop in the future and affect CF and PCD patients. This could manifest itself as the use of mental models, mental simulation, and story-building about possible future developments.
Decision-making	“[Q]uestioning the appropriateness of standard courses of action or default decisions […], considering trade-offs in ongoing plan trajectories […], sacrificing previous decisions or commitments” (Patterson & Hoffman, 2012, p. 222).	Meaning units reflecting how individuals try to make decisions about managing their daily lives and self-care in the presence of COVID-19. This could manifest itself as questions and answers illustrating how individuals make decisions while faced with uncertainty and risk posed by the pandemic, as well as competing assessments of the situation.
Replanning	”Organizations devote a lot of attention and resources to planning, but they spend even more of their time replanning – that is, in modifying, adjusting, or replacing a plan that is already being implemented.” (Crandall et al., 2006, p. 138–139).	Meaning units reflecting how CF and PCD care may need to be modified, adjusted, or replaced in response to COVID-19. This could manifest itself as questions and answers reflecting how individuals identify and take advantage of leverage points to construct new action plans.
Problem detection	“[N]otizing that events may be taking an unexpected direction” (Patterson & Hoffman, 2012, p. 222).	Meaning units reflecting how patients, family caregivers, or the CF learning network notice that events may be taking an unexpected direction. This could manifest itself in questions and answers reflecting a dissonance between existing mental models and unexpected or alarming developments.
Coordination	“[M]anaging interdependencies of activity and communication across individuals acting in roles that have common, overlapping, or interacting (and possibly conflicting) goals.” (Patterson & Hoffman, 2012, p. 222).	Meaning units reflecting how COVID-19 influences how team members organize their actions. This could manifest itself in questions and answers reflecting how team members communicate to maintain common ground.

Figure 1. Timeline illustrating the frequency (dot size) and categorization of questions that patients and family caregivers posed to the CF learning network. The questions are categorized by macrocognitive functions (sensemaking = purple, decision-making = red, replanning = green) and inductively generated themes (a-i).

Crandall, B., Klein, G., & Hoffman, R. (2006). Working minds: A practitioner’s guide to cognitive task analysis. MIT Press.

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Patterson, E. S., & Hoffman, R. R. (2012). Visualization framework of macrocognition functions. Cognition, Technology & Work, 14(3), 221–227. https://doi.org/10.1007/s10111-011-0208-1

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