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Exploring partners’ perspectives on participation in heart failure home-care: A mixed method design
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
Hanze University of Applied Sciences Groningen, Research Group Nursing Diagnostics, Groningen, the Netherlands.
Department of Care Science, Malmö University, and Department of Intensive Care and Perioperative Medicine, Skåne University Hospital, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Cardiology in Linköping.ORCID iD: 0000-0002-4259-3671
2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 5, p. 1208-1219Article in journal (Refereed) Published
Abstract [en]

Previous research has shown that partners are involved in the care of patients with heart failure. The aim of this study was to gain a better understanding of the partners ‘perspectives on participation in the care for patients with heart failure receiving structured home-care. A parallel convergent mixed method design with data from interviews analyzed with content analysis and questionnaires statistically analyzed (n=15). Results were analyzed with regard to whether they were comparable and convergent, expanded the understanding, or were inconsistent. Partners scored that they were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation; adapting to the caring needs and illness trajectory, mastering caregiving demands, interacting with health care providers, and gaining knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017. Vol. 73, no 5, p. 1208-1219
Keywords [en]
Caregivers, family, heart failure, home- care, mixed method, participation
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-117094DOI: 10.1111/jan.13216ISI: 000403110000019PubMedID: 27878851OAI: oai:DiVA.org:liu-117094DiVA, id: diva2:805495
Note

Funding agencies: European Commission [222954]; Linkoping University; Swedish Heart and Lung Association; Medical Research Council of Southeast Sweden; County Council Ostergotland, Sweden

The previous status of this publication was manuscript

Available from: 2015-04-15 Created: 2015-04-15 Last updated: 2018-04-19Bibliographically approved
In thesis
1. Participation in heart failure home-care: Patients’ and partners’ perspectives
Open this publication in new window or tab >>Participation in heart failure home-care: Patients’ and partners’ perspectives
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction: Patient participation is important for improving outcomes and respecting selfdetermination and legal aspects in care. Heart failure is a chronic condition that puts high demands on self-care and patient participation. Patients often need advanced care due to deterioration of their heart failure symptoms, and one option is to provide care as home-care. There is limited knowledge of how patients with heart failure and their partners view participation in home-care.

Aim: The overall aim of this thesis was to describe different perspectives of participation in structured heart failure home-care among patients with heart failure and their partners.

Methods: All patients in this thesis received structured heart failure home-care, according to a model aiming to facilitate care, where safety, participation, and gaining knowledge about the illness and treatment, are in focus. Study I had a prospective pre-post longitudinal design including 100 patients with heart failure receiving home-care. Data was collected by selfadministered questionnaires. Study II had a descriptive design. Nineteen patients receiving home-care were interviewed, and data was analysed using qualitative content analysis. Study III had a descriptive and explorative design. Data was collected by video-recorded observations of 19 home visits and analysed by qualitative content analysis. Study IV had a parallel convergent mixed-method design including 15 partners of patients receiving structured home-care. Data was collected by interviews and self-administered questionnaires. Datasets were first analysed separately and then together.

Results: Better self-care behaviour was significantly associated with all measured aspects of participation. Participation by received information increased significantly during the 12-month follow-up (I). Patients’ descriptions of participation included communication between patients and health care professionals, access to care, active involvement in care, a trustful relation with health care professionals, and options for decision-making(II). Observed care encounters revealed that participation was made possible by; (i) interaction, including exchange of care-related information, care-related reasoning, and collaboration, (ii) an enabling approach, including the patient expresses own wishes and shows an active interest, and the nurse is committed and invites to a dialogue (III). Partners scored fairly positive for their participation in care and they performed different levels of caregiving tasks. Descriptions of participation included; adapting to the caring needs and illness trajectory, mastering caregiving demands, interacting with care providers, and gaining knowledge to comprehend the health situation. The mixed-method results showed both convergent results and expanded knowledge (IV).

Conclusions: Structured heart failure home-care facilitated participation both for patients and their partners. Patient participation with regard to received information improved significantly after receiving home-care. Aspects of patient participation were consistently associated with better self-care behaviour. Patients’ and partners’ descriptions revealed many aspects of participation, and observed home visits revealed how interaction and an enabling approach underpinned participation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. p. 81
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1449
Keywords
Heart failure; home-care; involvement; mixed-method design; participation; partner; qualitative content analysis; self-care
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-117095 (URN)10.3384/diss.diva-117095 (DOI)978-91-7519-116-4 (ISBN)
Public defence
2015-05-13, Berzeliussalen, Campus US, LInköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2015-04-15 Created: 2015-04-15 Last updated: 2015-04-30Bibliographically approved

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Näsström, LenaStrömberg, Anna

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Division of Nursing ScienceFaculty of Medicine and Health SciencesResearch & Development Unit in Local Health CareDepartment of Cardiology in Linköping
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