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Rehabilitation after coronary heart disease: spouses’ views of support
Linköping University, Department of Medicine and Care. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.ORCID iD: 0000-0002-2646-8715
Linköping University, Department of Behavioural Sciences and Learning, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.ORCID iD: 0000-0001-5066-8728
Linköping University, Department of Medicine and Health Sciences, Cardiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Cardiology.
2004 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 46, no 2, 204-211 p.Article in journal (Refereed) Published
Abstract [en]

Background. Family presence decreases mortality and improves psychosocial recovery after a coronary heart disease event. In this situation, spousal support seems important for the recovering partner's self-esteem and mastery. There is inadequate knowledge of how spouses view their supportive roles.

Aim. The aim of this paper is to report a study investigating spouses' experiences of the rehabilitation phase of their partners' coronary heart disease and to gain their views about supporting them in lifestyle changes.

Method. Eight male (mean age 61) and 17 female spouses (mean age 53), were interviewed 1 year after their partner's cardiac event. Of the partners, 18 had experienced myocardial infarction and 19 were revascularized. Interview transcripts were analysed qualitatively using a phenomenographic framework.

Findings. The analysis yielded five different views of the spouse's role. The participative role involved taking a practical part in lifestyle changes, communicating empathetically, and being positive about changes. The regulative role was characterized by being either positive or negative about changes, giving practical or cognitive support in order to control the partner's behaviour, and communicating authoritatively. In the observational role the spouse was passive, complied with suggestions, and communicated empathetically. The incapacitated role involved a positive attitude to changes, communicating without making demands, but being unable to provide support because of personal problems. Assuming a dissociative role entailed being negative about changes and authoritatively declaring a reluctance to be involved in the partner's change of lifestyle. Spouses adopted different roles depending on the support situation.

Conclusion. Spouses' views of their roles in support varied considerably in terms of awareness of the benefits of behavioural changes, style of communication, pattern of co-operation and support situation. The findings favour the view that a family perspective is important in planning rehabilitation of patients following coronary heart disease.

Place, publisher, year, edition, pages
2004. Vol. 46, no 2, 204-211 p.
Keyword [en]
spouses, cardiac rehabilitation, support, communication, contextual analysis, phenomenography, nursing
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13743DOI: 10.1111/j.1365-2648.2003.02980.xOAI: diva2:21243
Available from: 2005-12-23 Created: 2005-12-23 Last updated: 2016-08-31
In thesis
1. Patients’ and Spouses’ Perspectives on Coronary Heart Disease and its Treatment
Open this publication in new window or tab >>Patients’ and Spouses’ Perspectives on Coronary Heart Disease and its Treatment
2005 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Lifestyle changes and drug treatment can improve the prognosis and quality of life for patients with coronary heart disease (CHD), but their co-operation with suggested treatment is often limited. The aim of this thesis was to study how patients and their spouses conceive CHD and its treatment.

Material and Methods: The research design used was inductive and descriptive. The studies were based on three complementary sets of data. Patients with CHD (n=23) and spouses (n=25) were interviewed one year after an episode of the disease. Consecutive patients with CHD derived from another investigation were interviewed within six weeks or one year after the coronary event (n=113). All semi-structured interviews, tape-recorded or from notes taken by hand, were subjected to analysis within the phenomenographic framework.

Findings: The patients’ conceptions of CHD varied and were vague, even as judged on a lay level. They were associated with symptoms rather than with the disease. Co-operation with drug treatment was rarely linked to improved prognosis. The patients’ descriptions of benefits from lifestyle changes and treatment did not give the impression of being based on a solid understanding of the importance of such changes. Incentives for lifestyle changes were classified into four categories, all of which contained both facilitating and constraining incentives. Somatic incentives featured direct and indirect physical signals. Social/practical incentives involved shared concerns, changed conditions, and factors connected with external environment. Cognitive incentives were characterised by active decisions and appropriated knowledge, but also by passive compliance with limited insights, and by the creating of routines. Affective incentives comprised fear and reluctance related to lifestyle changes and disease and also lessened self-esteem. All incentives mostly functioned facilitatively. The cognitive and the social/practical incentives were the most prevalent.

Spouses’ understanding about the causes of CHD involved both appropriate conceptions and misconceptions. Drug treatment was considered necessary for the heart, but harmful to other organs. Spouses’ support to partners was categorised, and found to be contextually bound. The participative role was co-operative and empathetic. The regulative role controlled and demanded certain behaviours. The observational role was passive, compliant, and empathetic. The incapacitated role was empathetic, unable to support, and positive to changes. The dissociative role was negative to changes and reluctant to be involved in lifestyle changes.

Conclusions: These results could be useful in the planning of care and education for CHD patients. The findings also emphasise the importance of adopting a family perspective to meet the complex needs of these patients and their spouses in order to facilitate appropriate lifestyle changes.

Place, publisher, year, edition, pages
Institutionen för medicin och vård, 2005
Linköping University Medical Dissertations, ISSN 0345-0082 ; 849
Causal attributions, coronary disease, drug treatment, lifestyle changes, phenomenography, patient adherence, spouses
National Category
Cardiac and Cardiovascular Systems
urn:nbn:se:liu:diva-5264 (URN)91-7373-824-7 (ISBN)
Public defence
2004-05-19, Täppan 1, Täppan, Campus Norrköping, Linköpings universitet, Norrköping, 09:00 (English)
On the day of the public defence of the doctoral thesis the status of article V was Submitted.Available from: 2005-12-23 Created: 2005-12-23 Last updated: 2016-08-31

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Kärner, AnitaAbrandt Dahlgren, MadeleineBergdahl, Björn
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