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Addressing spouses unique needs after cardiac surgery when recovery is complicated by heart failure
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medicine and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
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2009 (English)In: HEART and LUNG, ISSN 0147-9563, Vol. 38, no 4, 284-291 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience difficult and demanding situations when the partner becomes critically ill.

OBJECTIVES: To identify, describe, and conceptualize the individual needs of spouses of patients with complications of heart failure after cardiac surgery.

METHODS: Grounded theory using a mix of systematic coding, data analysis, and theoretical sampling was performed. Spouses, 10 women and 3 men between 39 and 85 years, were interviewed.

RESULTS: During analysis, the core category of confirmation was identified as describing the individual needs of the spouses. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among spouses.

CONCLUSIONS: By identifying spouses needs for security, rest for mind and body, and inner strength, health care professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions to confirm spouses needs are important because they are vital to the patients recovery.

Place, publisher, year, edition, pages
2009. Vol. 38, no 4, 284-291 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-20176DOI: 10.1016/j.hrtlng.2008.10.002OAI: oai:DiVA.org:liu-20176DiVA: diva2:233682
Available from: 2009-09-01 Created: 2009-08-31 Last updated: 2013-09-03Bibliographically approved
In thesis
1. Supportive care for patients with heart failure and their partners: A descriptive and interventional study
Open this publication in new window or tab >>Supportive care for patients with heart failure and their partners: A descriptive and interventional study
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Having the support of a partner is essential for both health related quality of life and survival in heart failure patients. However, caring for a patient with heart failure may affect the health related quality of life, well‐being and cause a burden for the partner. The partner is expected to be responsible for the care, which may have consequences for the heart failure patient’s long‐term health and well‐being. Further research to determine health related quality of life, well‐being, caregiver burden and needs of partners is warranted as well as studies evaluating interventions targeting patient‐partner dyads.

Aim: The overall aim was to describe how the life situation of patient‐partner dyads was influenced by heart failure and to determine the effects of an intervention of follow‐up with education and psychosocial support for patient‐partner dyads.

Design and methods: The thesis is based on three quantitative studies and one qualitative study. The first two studies were descriptive and included 135 dyads (patient‐partner) (I, II) and the randomised intervention study included a total of 155 dyads (IV). The qualitative study had a grounded theory approach. Thirteen partners were interviewed and data analysed using constant comparative method (III).

Results: Caregiver burden was perceived as moderate in 30% of the partners and the rest experienced a low caregiver burden. The patients’ physical component score of SF‐36, partners’ mental component score of SF‐36 and perceived control explained 39% of the caregiver burden (I). Patients had lower health related quality of life compared to their partners in all dimensions except in the mental health domain of SF‐36 and lower qualityadjusted life year weights compared to their partners. Mental health scores were lower in partners compared to age and gender‐matched references. All other health related quality of life scores and the quality‐adjusted life year weights were comparable between the partners and the reference group. Patients had more depressive symptoms than their partners. There was no difference in the level of perceived control or knowledge about chronic heart failure between patients and partners (II). During grounded theory analysis confirmation was identified as describing the core category of the partners’ individual needs. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among partners (III). At the three month follow‐up the dyad‐intervention had improved perceived control in patients, but not in the partners. There were no other significant differences in the control and intervention group with regard to the dyads’ health related quality of life and symptoms of depression. There were also no differences in the patients’ self‐care behaviour and partners’ experiences of caregiver burden (IV).

Conclusions and implications: Partners to patients with chronic heart failure are at risk of decreased mental well‐being. One third of the partners experienced a moderate caregiver burden and was therefore at a higher risk of poor mental health and decreased perceived control. During short‐term follow‐up the intervention with education and psychosocial support to dyads (patient‐partner) improved the level of perceived control in the chronic heart failure patient group. By identifying partnersʹ needs for security, rest for mind and body, and inner strength, healthcare professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions targeting dyads have been limited in previous research. Partners need to be prepared regarding the disease process, the daily regimen, hopes for the future and responsible care providers. They also need to be confirmed because they are vital to the patients’ recovery. Further, the effects of the intervention study should also include a long‐term follow‐up as well as an evaluation of the health‐economic perspective including direct and indirect costs of care.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. 71 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1181
Keyword
Heart failure, cardiac surgery, caregiver burden, intervention, health related quality of life, nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-56232 (URN)978-91-7393-406-0 (ISBN)
Public defence
2010-06-03, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 09:00 (English)
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Available from: 2010-05-03 Created: 2010-05-03 Last updated: 2017-07-07Bibliographically approved

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Ågren, SusannaHollman Frisman, GunillaBerg, SörenSvedjeholm, RolfStrömberg, Anna

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Ågren, SusannaHollman Frisman, GunillaBerg, SörenSvedjeholm, RolfStrömberg, Anna
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Nursing ScienceFaculty of Health SciencesDepartment of Thoracic and Vascular SurgeryThoracic SurgeryDepartment of Cardiology
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