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Vanzella LM, Rouse V, Ajwani F, Deilami N, Pokosh M, Oh P, Ghisi GLDM. Barriers and facilitators to participant adherence of dietary recommendations within comprehensive cardiac rehabilitation programmes: a systematic review. Public Health Nutr 2021; 24:4823-4839. [PMID: 34344495 PMCID: PMC11082819 DOI: 10.1017/s1368980021002962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 06/03/2021] [Accepted: 07/08/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To identify individual-, provider- and system/environmental-level barriers and facilitators affecting cardiac rehabilitation (CR) participants' adherence to dietary recommendations. DESIGN A systematic review of the medical literature was conducted. Six databases were searched from inception through March 2021: APA PsycInfo, CINAHL, Embase, Emcare, Medline and PubMed. Only those studies referring to barriers and facilitators reported by CR participants were considered. Pilot and case report studies, non-peer-reviewed literature and studies published in a language other than English, Portuguese or Spanish were excluded. RESULTS Data were extracted and analysed on the basis of individual-, provider- and system/environmental-level factors. Of 2083 initial citations, sixteen studies were included, with nine being qualitative and seven observational in design. From these, ten multi-level barriers and seven multi-level facilitators were identified. Dietary recommendations included developing healthy eating habits, transitioning to vegetarian-rich diets and increasing fish oil and n-3 intake. Only one study reported on all of the nutrition education programme factors recommended by the Workgroup for Intervention Development and Evaluation Research. CONCLUSION To the best of our knowledge, this review is the first to summarise specific barriers and facilitators to recommendation adherence among CR participants. Few of the studies offered any conclusions regarding programme design that could facilitate improved dietary adherence practices. Future studies should aim to explore patient perspectives on the nutritional patterns and recommendations outlined in the Mediterranean Diet, the Dietary Approaches to Stop Hypertension Diet, Vegetarian or Vegan diets and the Portfolio Diet.
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Affiliation(s)
- Lais Manata Vanzella
- São Paulo State University, School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil
| | - Veronica Rouse
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Fatim Ajwani
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Niloufar Deilami
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Maureen Pokosh
- Library and Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Paul Oh
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
| | - Gabriela Lima de Melo Ghisi
- Toronto Rehabilitation Institute, Cardiovascular Prevention and Rehabilitation Program, University Health Network, 347 Rumsey Road, Toronto, ONM4G 2R6, Canada
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Factors associated with anxiety and depression in hospitalized patients with first episode of acute myocardial infarction. ACTA ACUST UNITED AC 2017; 2:e90-e99. [PMID: 29379888 PMCID: PMC5777476 DOI: 10.5114/amsad.2017.72532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/29/2017] [Indexed: 12/20/2022]
Abstract
Introduction Evaluation of anxiety and depression in cardiac patients is an area of nursing practice that is frequently neglected. The aim of the study was to explore anxiety and depression in hospitalized patients with their first episode of acute myocardial infarction. Material and methods The study sample included 148 hospitalized patients who had a first episode of acute myocardial infarction. Data collection was performed by the interview method using a specially designed questionnaire which included socio-demographic, clinical and other patients’ characteristics as well as the Hospital Anxiety and Depression Scale (HADS) to assess patients’ levels of anxiety and depression. Results Analysis of data showed that 52% and 38% of participants had high levels of anxiety and depression, respectively. Furthermore, anxiety levels revealed a statistically significant association with anxiolytics (p = 0.005) and antidepressant medication (p = 0.026) in hospital, the belief that they will face difficulties in relations with the social and family environment (p = 0.009 and p = 0.002, respectively) and whether they considered themselves anxious (p = 0.003). Depression was statistically significantly associated with education level (p = 0.001), profession (p = 0.007), antidepressant medication in hospital (p ≤ 0.001), patients’ relations with nursing staff (p = 0.019) and patients’ belief that they will face difficulties in relations with the social and family environment (p ≤ 0.001 and p ≤ 0.001, respectively). Conclusions The results showed that socio-demographic and clinical characteristics should be taken into serious consideration when exploring anxiety and depression in patients with a first episode of acute myocardial infarction in order to implement appropriate interventions.
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Abstract
The purpose of this study was to describe the experiences of persons whose spouses have newly diagnosed coronary artery disease (CAD). The purpose was to obtain knowledge that would help us to understand better the life of persons with a chronically ill spouse and to develop the education and rehabilitation of both the patients and their spouses. Data were collected from healthy spouses by an open-ended question. There were 146 informants. They were asked to write about their experiences of everyday life after their spouse had been diagnosed for CAD. The data were analyzed by methods of content analysis. The following categories were formulated to describe the healthy spouses' experiences: slow pace of life, limited life and unsure life. Slow pace of life meant that the disease had been adopted as a normal part of life. Life was organized in a new way, and the earlier busy and work-oriented lifestyle had been given up. The informants whose spouses had medication considered their personal freedom to be limited, because they had to assume responsibility for the care of their spouses. The spouses of the patients who had undergone bypass surgery (CABS) or angioplasty (PTCA) had a new role in the family. They had to monitor for symptoms, treat symptoms, take care, understand and support. They had to assume responsibility for everyday life. They felt themselves to be alone in that situation. They did not receive support from health care providers. All informants felt uncertainty due to financial problems, poorly planned care and unexpected changes in the course of the disease. As a conclusion, it can be said that life was limited by the sick spouse's needs. The disease caused changes in emotional balance, a need for continuous control of life, fears about a new myocardial infarction and worries about many issues of everyday life.
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Affiliation(s)
- Hannele Lukkarinen
- Department of Nursing and Health Administration, University of Oulu, Oulu University Hospital, P.O. Box 5300, University of Oulu 90014, Finland.
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Steinke EE, Wright DW. The Role of Sexual Satisfaction, Age, and Cardiac Risk Factors in the Reduction of Post-MI Anxiety. Eur J Cardiovasc Nurs 2016; 5:190-6. [PMID: 16442845 DOI: 10.1016/j.ejcnurse.2005.12.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2005] [Revised: 12/08/2005] [Accepted: 12/15/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Anxiety is common after myocardial infarction (MI); however, little is known about the role of sexual satisfaction and return to sexual activity on anxiety post-MI. AIM To examine the role of sexual satisfaction in reducing anxiety post-MI. METHODS Patients with acute myocardial infarction (MI) recruited from one U.S. medical center completed questionnaires at baseline while hospitalized and at 1, 3, and 5 months post-MI. This analysis includes 64 patients compared on low or high anxiety at 5 months post-MI using sexual satisfaction and selected demographic and clinical variables in the analysis. RESULTS Patients with high anxiety scores reported lower sexual satisfaction (p < .001) and a higher percentage of coronary risk factors (p < .01). The OLS regression model provided similar results with an adjusted R-square of .422, accounting for approximately 42% of anxiety (p < .001). Sexual satisfaction accounted for the most variance in the model, showing an inverse relationship between sexual satisfaction and anxiety. An inverse relationship also existed between age and anxiety. CONCLUSIONS Anxiety is common after MI, and decreased sexual satisfaction appears to contribute to heightened anxiety. Attention to sexual concerns of MI patients before and after hospital discharge may improve psychosocial outcomes.
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Affiliation(s)
- Elaine E Steinke
- School of Nursing, Wichita State University, 1845 Fairmount, Wichita, Kansas, 67260-0041, USA.
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5
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Abstract
Family support has rarely been viewed as a relational phenomenon with interactional dynamics that shape individual and family experiences of cardiac recovery. This article describes a hermeneutic inquiry based on a retrospective review of videotapes of 24 clinical outpatient sessions between a family systems clinical nurse specialist and six families presenting with concerns related to living with heart disease. The research question that framed the analysis was “What is the relational character of family support during cardiac recovery?” One of the key patterns that emerged from the interpretations of clinical sessions with four of the six families was a dynamic well known in everyday experience and identified by families as “nagging.” This article reveals nagging as an attempt to offer emotional support and encouragement for health maintenance activities. The helpful and potentially harmful consequences are discussed and possibilities for incorporating these understandings in clinical practice are explored.
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6
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Paavilainen E, Lehti K, Astedt-Kurki P, Tarkka MT. Family Functioning Assessed by Family Members in Finnish Families of Heart Patients. Eur J Cardiovasc Nurs 2016; 5:54-9. [PMID: 16297662 DOI: 10.1016/j.ejcnurse.2005.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2004] [Revised: 03/23/2005] [Accepted: 10/03/2005] [Indexed: 11/27/2022]
Abstract
BACKGROUND The role of family is central to the wellbeing and health of individuals. Family attitudes, habits and routines affect the way individuals promote their health. Family functioning and family health are threatened when one family member develops heart disease. AIMS The aim of the study was to describe family functioning and to ascertain factors related to family functioning of families with heart patient as assessed by family members. METHODS Data collection was done using a questionnaire (FAFHES) in 2000. The sample consisted of 161 family members of patients receiving treatment on two medical wards. The data were analysed by means and tested by parametric and non-parametric tests. The multivariate method used was stepwise regression analysis. RESULTS The better the family values were materialized and the greater the family's contribution to family health, the better the family's functioning is. Concrete aid was also related to family health. The more concrete aid the family received from nurses, the better family functioning is. When the background variables were included, values and activities remained in the model, but two new variables explained family functioning: family member's age and knowledge of health issues. The older the family member is and the better the knowledge in the family is, the better is family functioning. CONCLUSION Family functioning of families with heart patients can be supported and developed by family nursing, e.g. concrete aid from nurses. Other aspects of support, e.g. consideration of family member's age and knowledge of health issues also need to be further considered and studied as the basis of care.
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Affiliation(s)
- Eija Paavilainen
- University of Tampere, Department of Nursing Science, Etelä-Pohjanmaa Hospital District, FIN-33014, Finland.
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Albarran JW, Tagney J, James J. Partners of ICD Patients—An Exploratory Study of Their Experiences. Eur J Cardiovasc Nurs 2016; 3:201-10. [PMID: 15350229 DOI: 10.1016/j.ejcnurse.2004.06.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Revised: 06/21/2004] [Accepted: 06/22/2004] [Indexed: 11/21/2022]
Abstract
BACKGROUND The experiences of partners who care for and support the needs of a loved one with an implantable cardiac defibrillator (ICD) remain largely unknown within Europe. AIMS This study explored the nature of partner's experiences from the pre-ICD implantation phase up until a maximum of 20 months at home. METHODS Eight partners cohabiting with a recipient of an ICD were interviewed using a semistructured schedule. All interviews were transcribed and content analysed for emerging categories and themes. FINDINGS Four themes representing 11 categories conceptualised the partners' experiences, these included: Acknowledging the patient's need for the device, reactions to the device, safeguarding the patient, and returning to normality. CONCLUSION This qualitative study suggests that partners of ICD recipients progress through various difficult and adaptive stages when learning how best to support the patient. A point is reached when most are able to assume control and normalise their lives. This transformation is slow; however, to improve this process and empower partners, nurses should provide relevant information and include them in decisions affecting the patient. Further research into the unique needs of partners, which includes international perspectives, would be significant in developing practice and theory in this area.
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Affiliation(s)
- John W Albarran
- Faculty of Health and Social Care, Critical Care Nursing, University of the West of England, Glenside Campus, Blackberry Hill, Bristol, BS16 1DD, UK.
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8
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Dougherty CM, Fairbanks AM, Eaton LH, Morrison ML, Kim MS, Thompson EA. Comparison of patient and partner quality of life and health outcomes in the first year after an implantable cardioverter defibrillator (ICD). J Behav Med 2015; 39:94-106. [PMID: 26345262 DOI: 10.1007/s10865-015-9671-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 08/13/2015] [Indexed: 02/04/2023]
Abstract
Recovery following an implantable cardioverter defibrillator (ICD) impacts both the patient and partner, often in divergent ways. Patients may have had a cardiac arrest or cardiac arrhythmias, whereas partners may have to perform CPR and manage the ongoing challenges of heart disease therapy. Currently, support for post-ICD care focuses primarily on restoring patient functioning with few interventions available to partners who serve as primary support. This descriptive study examined and compared patterns of change for both patients and partners during the first year post-ICD implantation. For this longitudinal study, the sample included 42 of 55 (76.4 %) patient-partner dyads who participated in the 'usual care' group of a larger intervention RCT with patients following ICD implant for secondary prevention of cardiac arrest. Measures taken at across five time points (at hospital discharge and at 1, 3, 6 and 12 months follow up) tracked physical function (SF-12 PCS, symptoms); psychological adjustment (SF-12 MCS; State-Trait Anxiety Inventory; CES-D); relationship impact (Family Functioning, DOII; Mutuality and Interpersonal Sensitivity, MIS); and healthcare utilization (ED visits, outpatient visits, hospitalizations). Repeated measures analysis of variance was used to characterize and compare outcome trends for patients and partners across the first 12 months of recovery. Patients were 66.5 ± 11.3 (mean + SD) years old, predominately Caucasian male (91 %), with Charlson co-morbidities of 4.4 ± 2.4. Partners were 62.5 ± 11.1 years old, predominantly female (91 %) with Charlson co-morbidities of 2.9 ± 3.0. Patient versus partner differences were observed in the pattern of physical health (F = 10.8, p < 0.0001); patient physical health improved while partner health showed few changes. For partners compared to patients, anxiety, depression, and illness demands on family functioning tended to be higher. Patient mutuality was stable, while partner mutuality increased steadily (F = 2.5, p = 0.05). Patient sensitivity was highest at discharge and declined; partner sensitivity increased (F = 10.2, p < 0.0001) across the 12-month recovery. Outpatient visits for patients versus partners differed (F = 5.0, p = 0.008) due most likely to the number of required patient ICD visits. Total hospitalizations and ED visits were higher for patients versus partners, but not significantly. The findings highlight the potential reciprocal influences of patient and partner responses to the ICD experience on health outcomes. Warranted are new, sound and feasible strategies to counterbalance partner needs while simultaneously optimizing patient recovery outcomes.
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Affiliation(s)
- Cynthia M Dougherty
- Biobehavioral Nursing and Health Systems, University of Washington School of Nursing, 1959 NE Pacific Street, HSB T615A, Box 357266, Seattle, WA, 98195-7266, USA.
| | | | - Linda H Eaton
- University of Washington School of Nursing, Seattle, WA, USA
| | | | - Mi Sun Kim
- University of Washington School of Nursing, Seattle, WA, USA
| | - Elaine A Thompson
- Psychosocial and Community Health, University of Washington School of Nursing, Seattle, WA, USA
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Psychological distress in spouses of somatically Ill: longitudinal findings from the Nord-Trøndelag Health Study (HUNT). Health Qual Life Outcomes 2014; 12:139. [PMID: 25214043 PMCID: PMC4173137 DOI: 10.1186/s12955-014-0139-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 08/29/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies of caregiver burden and somatic illness tend to be based on relatively small, clinical samples. Longitudinal, population based studies on this topic are still scarce and little is known about the long-term impact of partner illness on spousal mental health in the general population. In this study we investigate whether spouses of partners who either have become somatically ill or cured from illness in an 11 year period - or who have long-term illness - have different mental health scores compared to spouses of healthy partners. METHODS Approximately 9000 couples with valid self-report data on a Global Mental Health (GMH) scale and somatic illness status were identified. The diagnoses stroke, angina pectoris, myocardial infarction and severe physical disability, were transformed into a dichotomous 'any illness'-scale, and also investigated separately. Analyses of variance (ANOVA) stratified by sex were conducted with spousal GMH score at follow-up (1995-97, T2) as the outcome variable, adjusting for spousal GMH score at baseline (1984-86, T1) and several covariates. RESULTS Results showed that male and female spouses whose partners had become somatically ill since T1 had significantly poorer mental health than partners in the reference category, comprising couples healthy at both time points. Further, female spouses of partners who had recovered from illness since T1 had significantly better mental health than controls. Of the somatic conditions, physical disability had the most significant contribution on spousal GMH, for both sexes, in addition to stroke on male spouses' GMH. The effect sizes were small. Some of the loss of spousal mental health seems to be mediated by the ill persons' psychological distress. CONCLUSION The occurrence of partner illness during the follow-up period affect the mental health of spouses negatively, while partner recovery appeared to be associated with improved mental health scores for female spouses. Of the measured conditions, physical disability had the largest impact on spousal distress, but for some conditions the distress of the ill person mediated much of the loss of mental health among spouses.
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Challenges, needs, and experiences of recently hospitalized cardiac patients and their informal caregivers. J Cardiovasc Nurs 2014; 29:29-37. [PMID: 23416934 DOI: 10.1097/jcn.0b013e3182784123] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cardiovascular disease (CVD) is the leading cause of death in the United States. Unpaid family caregivers of patients who experienced a cardiac event may occupy a key position in disseminating continuous health messages to these patients, yet more information is needed to guide the development of educational and behavioral interventions targeting caregivers. OBJECTIVE The purpose of this qualitative study was to assess the challenges, needs, and personal experiences of cardiac patients and their informal caregivers to explore the types of programs and services that would be most beneficial in promoting adherence to national CVD guidelines among cardiac patients and their caregivers. METHODS Patients who had been admitted to the cardiovascular service line of a large urban academic medical center and their informal caregivers (N = 38, 63% women, 74% white) participated in semistructured interviews and focus groups. Participants were asked to speak about 4 major categories of their personal experiences: support, challenges, coping, and program delivery, to determine their needs, the kind of educational interventions that would be most helpful to them, and how they would prefer this information/education to be delivered. RESULTS Both patients and caregivers ranked diet as the most pressing challenge (91% and 78%, respectively). The Internet, television, and social media were the preferred methods of delivery of such programs. Challenges most commonly cited by caregivers and patients included issues related to taking/administering prescribed medications and medication side effects, and mental stress. Caregivers expressed that not knowing what to expect after the patient's discharge from the hospital was a major stressor. CONCLUSION These findings may inform the development of educational interventions targeted to cardiac caregivers so that they may be more effective in assisting the patients in their care to adhere to national CVD prevention guidelines.
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Leigh ES, Wikman A, Molloy GJ, Randall G, Steptoe A. The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome. Psychol Health 2014; 29:737-52. [DOI: 10.1080/08870446.2014.882921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Salonen P, Rantanen A, Kellokumpu-Lehtinen PL, Huhtala H, Kaunonen M. The quality of life and social support in significant others of patients with breast cancer--a longitudinal study. Eur J Cancer Care (Engl) 2013; 23:274-83. [PMID: 24237363 DOI: 10.1111/ecc.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2013] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate prospectively the quality of life (QOL) and received social support from the network and nurses in significant others of breast cancer patients and identify factors predicting negative changes in their QOL within 6 months. The quasi-random longitudinal study conducted for the breast cancer patients and their significant others. Patients were quasi-randomised to supportive intervention group (via telephone at baseline and face-to-face at follow-up) and control group. This paper reports results of significant others (N = 165). The QOL data were collected using the Quality of Life Index - Cancer Version (QLI-CV). Support from network in aid increased the risk of negative changes in health and functioning. Retired significant others had a greater risk of more negative changes in their global and in socio-economic QOL than other. Relatives had a smaller risk to negative changes both in their global and in their family QOL than spouses/partners/boyfriends of patients with breast cancer. QOL of the significant others should be supported more intensively and enhanced by the use of individually tailored methods on the basis of significant others and their family needs.
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Affiliation(s)
- P Salonen
- Tauh Division of Administrative Services, Tampere University Hospital, Tampere, Finland
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13
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Steinke EE, Mosack V, Hertzog J, Wright DW. A social-cognitive sexual counseling intervention post-MI-development and pilot testing. Perspect Psychiatr Care 2013; 49:162-70. [PMID: 23819666 DOI: 10.1111/j.1744-6163.2012.00345.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Individuals experiencing myocardial infarction (MI) report anxiety, depression, diminished quality of life (QOL), and reduced sexual activity. DESIGN AND METHODS We examined return to sexual activity post-MI, and pilot tested a comprehensive sexual counseling intervention based on social-cognitive theory. The intervention in this pretest/posttest preexperimental study used an informational video, newsletters, and telephone counseling, with cardiac patients (N = 10) and partners (N = 3). Measures included QOL; knowledge; sexual anxiety, depression, self-efficacy, and satisfaction. FINDINGS At 8 weeks, only 60% had returned to sexual activity, with low QOL and sexual satisfaction for patients and partners. PRACTICE IMPLICATIONS Supportive interventions by nurses are needed to assist MI patients and partners return to sexual activity.
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Affiliation(s)
- Elaine E Steinke
- School of Nursing, Wichita State University, Wichita, Kansas, USA.
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Salminen-Tuomaala MH, Åstedt-Kurki P, Rekiaro M, Paavilainen E. Coping with the effects of myocardial infarction from the viewpoint of patients' spouses. JOURNAL OF FAMILY NURSING 2013; 19:198-229. [PMID: 23584761 DOI: 10.1177/1074840713483922] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The spouse of a patient who has experienced a myocardial infarction (MI) reportedly has psychological and social needs and challenges during the patient's hospitalization but there is a lack of knowledge regarding spouses' coping experiences and resources. The aim of this study was to develop a substantive theory to help explain the coping experiences of the spouse during the patient's hospitalization following an acute MI. Twenty eight spouses of patients in two Finnish hospitals participated in an open-ended interview within 2 to 5 days of the MI and included 12 husbands and 16 wives. The core category "Seeking balance" included the spouses' emotional, cognitive, and social coping experiences following an acute MI. This study adds new information about spouses' coping experiences as well as tensions and problems in interaction between the patient and the spouse. Challenges were reported in talking about serious illness concerns between the spouse and patient and also with other family members.
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Borren I, Tambs K, Idstad M, Ask H, Sundet JM. Psychological distress and subjective well-being in partners of somatically ill or physically disabled: the Nord-Trøndelag Health Study. Scand J Psychol 2012; 53:475-82. [PMID: 23170864 DOI: 10.1111/sjop.12009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study investigated the cross-sectional associations between various somatic conditions in one partner and the level of distress and well-being in the spouse. The study is based on survey data from the Norwegian Nord-Trøndelag Health Study, HUNT II (1995-1997). A sample of 9,797 married or cohabiting couples with valid data on subjective well-being (SWB), psychological distress (Hopkins Symptom Check List (SCL)-10) and somatic illness were identified. Regression analyses stratified by sex were conducted with SCL-10 and SWB scores as dependent variables and a joint somatic score as predictor, including; stroke, cancer, angina, myocardial infarction and physical disability (PD). The contribution of each somatic condition was also explored. Spouses of persons previously diagnosed with at least one somatic condition scored significantly lower on SWB and significantly higher on SCL-10 than spouses of healthy persons, though effect sizes were small. The effect seems to be at least partly mediated by the ill partner's psychological distress. Of the specific conditions, PD had the most significant contribution for both genders, though an association between male angina and spousal distress/SWB was also demonstrated.
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Affiliation(s)
- Ingrid Borren
- Norwegian Institute of Public Health, Division of Mental Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway.
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Andersson EK, Borglin G, Sjöström-Strand A, Willman A. Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction. Scand J Caring Sci 2012; 27:864-71. [DOI: 10.1111/j.1471-6712.2012.01094.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 08/22/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Ewa Kazimiera Andersson
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Health Sciences; Lund University; Lund Sweden
| | - Gunilla Borglin
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Nursing; Karlstad University; Karlstad Sweden
| | | | - Ania Willman
- School of Health Science; Blekinge Institute of Technology; Karlskrona Sweden
- Department of Care Science; Malmö University; Malmö Sweden
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Salminen-Tuomaala M, Åstedt-Kurki P, Rekiaro M, Paavilainen E. Spouses’ coping alongside myocardial infarction patients. Eur J Cardiovasc Nurs 2012; 12:242-51. [DOI: 10.1177/1474515111435603] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mari Salminen-Tuomaala
- School of Health Sciences, Nursing Science, University of Tampere, Finland
- Seinäjoki University of Applied Sciences, Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science, University of Tampere, Finland
- Science Centre, Finland
| | - Matti Rekiaro
- Centre For Pharmacotherapy Development, Seinäjoki, Finland
| | - Eija Paavilainen
- School of Health Sciences, Nursing Science, University of Tampere, Finland
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Altıok M, Yılmaz M. Opinions of Individuals Who have had Myocardial Infarction About Sex. SEXUALITY AND DISABILITY 2011. [DOI: 10.1007/s11195-011-9217-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rantanen A, Tarkka MT, Kaunonen M, Tarkka M, Sintonen H, Koivisto AM, Astedt-Kurki P. Health-related quality of life after coronary artery bypass grafting. J Adv Nurs 2009; 65:1926-36. [PMID: 19694856 DOI: 10.1111/j.1365-2648.2009.05056.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM The purpose of this study was to monitor changes in health-related quality of life and to identify associated factors among patients having coronary artery bypass grafting and their significant others. BACKGROUND Heart disease and its treatment affects the lives of both patients and their significant others, and the early stage of recovery from surgery causes particular anxiety for both. METHOD In this longitudinal study, three sets of questionnaire data were collected 1, 6 and 12 months after coronary artery bypass grafting surgery from patients and significant others at one university hospital in Finland in 2001-2005. We recruited all patients who had been admitted for elective coronary artery bypass grafting surgery during the period specified. The data consisted of the responses from those patients and significant others who had completed all three questionnaires and for whom patient-significant other pairs existed (n = 163). FINDINGS Patients' and their significant others' health-related quality of life was at its lowest one month after the operation and improved during follow-up. The change in the mean health-related quality of life score differed between patients and significant others; the improvement in the patients' health-related quality of life was greater than that in the significant others. Neither the background variables used in the study nor social support were associated with change in health-related quality of life. CONCLUSION Further research is needed to identify factors explaining the change in health-related quality of life to develop interventions to support patients and significant others.
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Affiliation(s)
- Anja Rantanen
- Department of Nursing Science, University of Tampere, Finland.
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Eriksson M, Asplund K, Svedlund M. Patients' and Their Partners' Experiences of Returning Home after Hospital Discharge Following Acute Myocardial Infarction. Eur J Cardiovasc Nurs 2009; 8:267-73. [DOI: 10.1016/j.ejcnurse.2009.03.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2008] [Revised: 02/13/2009] [Accepted: 03/30/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
| | - Kenneth Asplund
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Marianne Svedlund
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden
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22
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Dougherty CM, Thompson EA. Intimate partner physical and mental health after sudden cardiac arrest and receipt of an implantable cardioverter defibrillator. Res Nurs Health 2009; 32:432-42. [PMID: 19434648 DOI: 10.1002/nur.20330] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose of this study was to describe the physical and mental health of the intimate partners of persons receiving an implantable cardioverter defibrillator (ICD). A prospective longitudinal repeated measures design was used, with data collected at hospital discharge, and at 1, 3, 6, and 12 months after implantation. Intimate partners' physical health, symptoms, and depression significantly declined over the first year. Although anxiety was significantly reduced over time, it remained elevated in partners after 1 year. The impact of implantation of the ICD on the intimate relationship and care demands was most dramatic at hospital discharge. Health care use was low throughout the year. Intimate partners could benefit from an intervention that would assist in their psychological adjustment and provide strategies for dealing with caregiving demands at home.
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Affiliation(s)
- Cynthia M Dougherty
- Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington, Box 357266, Seattle, WA, USA
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23
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Patients' and significant others' health-related quality of life one month after coronary artery bypass grafting predicts later health-related quality of life. Heart Lung 2009; 38:318-29. [DOI: 10.1016/j.hrtlng.2008.07.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Revised: 05/06/2008] [Accepted: 07/30/2008] [Indexed: 11/22/2022]
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Randall G, Molloy GJ, Steptoe A. The impact of an acute cardiac event on the partners of patients: a systematic review. Health Psychol Rev 2009. [DOI: 10.1080/17437190902984919] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rantanen A, Kaunonen M, Sintonen H, Koivisto AM, Astedt-Kurki P, Tarkka MT. Factors associated with health-related quality of life in patients and significant others one month after coronary artery bypass grafting. J Clin Nurs 2008; 17:1742-53. [PMID: 18592625 DOI: 10.1111/j.1365-2702.2007.02195.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To describe and compare the health-related quality of life of patients and their significant others and to identify factors associated with health-related quality of life one month after coronary artery bypass surgery. BACKGROUND Heart disease and coronary artery bypass surgery affect the life of patients and their significant others. Following surgery, some patients might feel their quality of life is poor. Significant others are a major source of support for patients; therefore, it is important to know how their health-related quality of life is affected. METHODS This study is part of a major longitudinal research project. The questionnaire data for the study were collected one month after the surgical procedure from 270 patients and 240 significant others at one Finnish university hospital. Data analysis was by descriptive and inferential statistics. Stepwise linear regression analysis was used as a multivariate method. RESULTS Coronary artery bypass grafting patients had a poorer health-related quality of life than both the age and gender-standardised general population and their significant others. Significant others, on the other hand, had the same health-related quality of life as the general population. In patients, health-related quality of life was associated with the occurrence of cardiac symptoms and New York Heart Association class; in significant others, it was explained by chronic illnesses, employment, gender and emotional support received from members of the support network. CONCLUSION In the early stages of recovery, the health-related quality of life of coronary artery bypass grafting patients is inferior to that of the general population. There are also differences in the health-related quality of life of patients and their significant others. RELEVANCE TO CLINICAL PRACTICE Postcoronary artery bypass grafting rehabilitation programmes should provide support for both patients and significant others through networks that involve both professionals and peer supporters.
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Affiliation(s)
- Anja Rantanen
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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Astin F, Atkin K, Darr A. Family Support and Cardiac Rehabilitation: A Comparative Study of the Experiences of South Asian and White-European Patients and Their Carer's Living in the United Kingdom. Eur J Cardiovasc Nurs 2008; 7:43-51. [DOI: 10.1016/j.ejcnurse.2007.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Revised: 06/19/2007] [Accepted: 06/20/2007] [Indexed: 11/16/2022]
Abstract
Background: Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. Aims: To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Methods: Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. Results: The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Conclusions: Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not.
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Affiliation(s)
- Felicity Astin
- University of Leeds School of Healthcare, Baines Wing LS2 9JT United Kingdom
| | - Karl Atkin
- University of Leeds School of Healthcare, Baines Wing LS2 9JT United Kingdom
- Department of Health Sciences, Seebohm Rowntree Building (Area Four), University of York, York, YO10 5DD, United Kingdom
| | - Aliya Darr
- University of Leeds School of Healthcare, Baines Wing LS2 9JT United Kingdom
- Institute of Health Sciences and Public Health, Hallas Wing, 71-75 Clarendon Road, United Kingdom
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Westin L, Nilstun T. Principles help to analyse but often give no solution--secondary prevention after a cardiac event. HEALTH CARE ANALYSIS 2007; 14:111-7; discussion 119-22. [PMID: 17195579 DOI: 10.1007/s10728-006-0016-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The aim of this paper is to investigate whether or not ethical conflicts can be identified, analysed and solved using ethical principles. The relation between the physician and the patient with ischemic heart disease (IHD) as life style changes are recommended in a secondary prevention program is used as an example. The principal persons affected (the patient and his or her spouse) and the ethical principles (respect for autonomy, non-maleficence, beneficence and justice) are combined in a two dimensional model. The most important person affected by the recommendations is the patient. His or her autonomy is challenged by the suggested life style changes, the purpose of which is to promote the future wellbeing and health of the patient. The spouse is indirectly involved in and affected by the process. He or she often feels neglected by caregivers. Ethical conflicts can both be identified and analysed using ethical principles, but often no solution is implied. Most (if not all) physicians would strongly encourage life style changes, but surprisingly there is no uncontroversial justification for this conclusion using principles.
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Affiliation(s)
- Lars Westin
- Department of Medical Ethics, University of Lund, Sweden.
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Ziegert K, Fridlund B, Lidell E. Professional support for next of kin of patients receiving chronic haemodialysis treatment: a content analysis study of nursing documentation. J Clin Nurs 2007; 16:353-61. [PMID: 17239071 DOI: 10.1111/j.1365-2702.2006.01597.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM AND OBJECTIVES The aim of this study was to examine the content of nursing documentation with a focus on professional support for next of kin (NoK) of patients receiving chronic haemodialysis treatment. BACKGROUND Professional support in nursing focuses on promotion, maintenance and restoration of health and prevention of illness. DESIGN The study had a descriptive design and qualitative content analysis was used to search for themes based on descriptions contained in the collected nursing documentation. METHODS The total number of nursing records of patients receiving chronic haemodialysis treatment (n = 50) for the 5-year period 1998-2002 was included. All nursing documentation was systematic in accordance with the VIPS-documentation model. RESULTS The professional support could be described within the framework of three themes: to explore NoK's supportive resources, to enable NoK' readiness in caring for the patient and to co-operate with NoK in the care of the patient in the home, captured by the core theme which described the professional support as a continuous process. CONCLUSIONS Next of kin are a supportive resource in the nursing care of patients receiving chronic haemodialysis treatment and professional support for NoK focuses on planning their participation in the care of patients in the home. RELEVANCE TO CLINICAL PRACTICE Professional support for NoK should be documented in family focused nursing diagnoses, which would make it possible to search for different types of support. Future research might explore nurses' or NoK's views on carer support.
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Affiliation(s)
- Kristina Ziegert
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
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Abstract
AIM This paper reports a review analysing the use of factor analysis in papers in Journal of Advanced Nursing. BACKGROUND Factor analysis is a multivariate statistical method for reducing large numbers of variables to fewer underlying dimensions. There are several methods of factor analysis with principal components analysis being the most commonly applied. Factor analysis has been used by researchers in nursing for many years but the standards for use and reporting are variable. METHOD Papers using factor analysis in Journal of Advanced Nursing were retrieved from 1982 to the end of 2004. The search term 'factor analysis' was used in the CINAHL database and applied specifically to Journal of Advanced Nursing in December 2004. Retrieved papers were included in the review if they came from Journal of Advanced Nursing and used factor analysis as part of the method of the reported study. RESULTS One hundred and twenty-four papers were retrieved as a result of the initial search criteria of which 116 were from Journal of Advanced Nursing. Screening of papers for the use of factor analysis left 100 papers for review. Principal components analysis was the most commonly used method of factor analysis; Eigenvalues greater than one was the most commonly applied criterion for selecting the number of factors followed by orthogonal rotation to achieve simple structure. The majority of papers did not report the whole factor solution and there were papers that did not specify anything beyond the fact that they carried out factor analysis. Confirmatory factor analysis was rarely used and exploratory methods other than principal components analysis were also rarely used. CONCLUSIONS Factor analysis is quite commonly used in nursing research reported in Journal of Advanced Nursing. While some papers are exemplary there is room for improvement in the reporting of all aspects of factor analysis.
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Affiliation(s)
- Roger Watson
- Graduate Division of Nursing and Midwifery School of Nursing and Midwifery, The University of Sheffield, Sheffield, UK.
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Pihl E, Jacobsson A, Fridlund B, Strömberg A, Mårtensson J. Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study. Eur J Heart Fail 2005; 7:583-9. [PMID: 15921798 DOI: 10.1016/j.ejheart.2004.07.016] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2003] [Revised: 07/14/2004] [Accepted: 07/29/2004] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Little is known about the factors that influence the health outcome of elderly patients suffering from heart failure or the health of their spouses. The aim of this comparative study was to determine if older patients suffering from heart failure and their spouses experience similar levels of health-related quality of life (HRQOL) and depression. The aim was also to identify those factors that contribute to HRQOL and depression in patient-spouse pairs. METHODS Data were collected from 47 couples, using the Short Form 36 (SF-36) and Zung Self-rating Depression Scale (SDS) questionnaires. RESULTS Patients suffering from heart failure and their spouses differed significantly in their experience of the physical, but not the mental, health-related quality of life, with patients experiencing significantly worse physical functioning. Physical symptoms of heart failure seemed to dominate the experience of the patient and was positively related to mental health and inversely related to the New York Heart Association classification (NYHA class) and patients' depression. Depressive symptoms as reflected in SDS showed no significant difference between patients and spouses. Patients' depression was positively related to high NYHA class, while spouse depression was positively related with higher age of the patient. CONCLUSION Physical symptoms seem to dominate the experience of heart failure.
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Affiliation(s)
- Emma Pihl
- Department of Medicine, Cardiac Care Unit, Halmstad Central Hospital, Halmstad, Sweden.
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31
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Response. J Clin Nurs 2005. [DOI: 10.1111/j.1365-2702.2004.01065.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Svedlund M, Danielson E. Myocardial infarction: narrations by afflicted women and their partners of lived experiences in daily life following an acute myocardial infarction. J Clin Nurs 2004; 13:438-46. [PMID: 15086630 DOI: 10.1111/j.1365-2702.2004.00915.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The review of the literature showed that many people and their family members share feelings of distress after an acute myocardial infarction. Therefore, it is important to show how the illness affects the relationship in the couple's daily life when the closest relatives involved are men. AIM The aim was to illuminate the meaning of lived experiences in daily life after an acute myocardial infarction, as narrated by afflicted women and their partners. METHODS Nine women and their partners narrated their experiences three and 12 months after an infarction. The interview texts were then interpreted, using a phenomenological hermeneutic method, inspired by the philosophy of Ricoeur. The text was divided into meaning units that were condensed and abstracted. Two themes and eight sub-themes were then extracted from the text. RESULTS The first theme was 'living in a changed life situation' with the sub-themes: 'showing consideration', 'taking responsibility', 'living side by side' and 'desiring what to do'. The second theme was 'looking to the future' with the sub-themes: 'feeling uncertain', 'feeling powerless', 'feeling limited' and 'feeling hope'. CONCLUSIONS The results revealed that couples lived in a changed life situation, somewhat in 'discordance', and showed consideration to each other in order to protect the partner. There seemed to be a lack of verbal communication, but both women and their partners revealed that they sensed how their partners felt without verbal communication. In this 'discordance', couples may experience loneliness, in that they may not share feelings about the event and the situation it causes. RELEVANCE TO CLINICAL PRACTICE Women and their partner have specific needs in daily living following an acute myocardial infarction. Therefore, nurses should acknowledge the specific needs for the female patient and the partner more clearly.
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Affiliation(s)
- Marianne Svedlund
- Department of Nursing and Health Sciences, Mid Sweden University, Ostersund, Sweden.
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33
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Kärner AM, Dahlgren MA, Bergdahl B. Rehabilitation after coronary heart disease: spouses' views of support. J Adv Nurs 2004; 46:204-11. [PMID: 15056334 DOI: 10.1111/j.1365-2648.2003.02980.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Anita M Kärner
- Department of Medicine and Care, Division of Cardiology, Faculty of Health Sciences, Linköping University, Sweden.
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Rantanen A, Kaunonen M, Astedt-Kurki P, Tarkka MT. Coronary artery bypass grafting: social support for patients and their significant others. J Clin Nurs 2004; 13:158-66. [PMID: 14723667 DOI: 10.1046/j.1365-2702.2003.00847.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patients and significant others may experience physical and psychological stress symptoms during the recovery time from coronary artery bypass surgery. It has been shown that social support is associated with health and well-being in various situations. It is important to study how patients and significant others describe the social support received. AIM AND OBJECTIVE To describe social support for bypass surgery patients and their significant others from the social network and nurses during hospitalization and the association between demographic variables and support received from nurses. DESIGN A descriptive study using a questionnaire. This was a pilot study. METHOD Questionnaires were mailed to 146 subjects and 103 responded. The questionnaires included background variables, the Social Support from the Social Network Scale and the Support from Nurses during Hospitalization Scale. RESULTS In most cases, the spouse, children and friends were the major sources of support for patients and significant others. Patients reported equal amounts of both affect and aid or concrete support while significant others reported the highest level of affect and the lowest level of affirmation from the social network. Patients and significant others reported the highest level of affirmation and the lowest level of aid from nurses during hospitalization. CONCLUSIONS Relatives are important sources of support for bypass surgery patients and their significant others. Patients reported higher levels of all types of social support from both the social network and nurses than did significant others. RELEVANCE TO CLINICAL PRACTICE The provision of nursing support for significant others can be enhanced by focusing nursing care on the whole family. This would promote the health of the whole family.
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Affiliation(s)
- Anja Rantanen
- Department of Nursing Science, University of Tampere, Tampere, Finland.
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35
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Williamson GR. Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing. J Adv Nurs 2003; 44:278-88. [PMID: 14641398 DOI: 10.1046/j.1365-2648.2003.02803.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed. BACKGROUND Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable. DISCUSSION The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. REVIEW LIMITATIONS: This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s). CONCLUSION Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples.
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Tarkka MT, Paavilainen E, Lehti K, Astedt-Kurki P. In-hospital social support for families of heart patients. J Clin Nurs 2003; 12:736-43. [PMID: 12919220 DOI: 10.1046/j.1365-2702.2003.00771.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chronic illness in one family member influences all aspects of family life. Research has documented the positive contributions of social support in an unexpected and stressful event such as a family member's heart disease. The aim of the study was to describe in-hospital social support provided by nurses to families of heart patients and to identify factors related to social support. Data were collected using a mailed questionnaire to family members of heart patients (n = 161) receiving treatment on two medical wards of a university hospital in southern Finland. The results show that the family members were not very satisfied with the social support from nurses, because about 40% were dissatisfied with the concrete aid and affirmation they received and about 30% with emotional support. According to regression analysis the most important predictors of social support were family structure, patient's age, gender of family member and whether the patient had been hospitalized for cardiac symptoms. This report shows that supporting families of cardiac patients need development according to the family nursing practice.
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Santavirta N, Kettunen S, Solovieva S. Coping in spouses of patients with acute myocardial infarction in the early phase of recovery. J Cardiovasc Nurs 2001; 16:34-46. [PMID: 11587239 DOI: 10.1097/00005082-200110000-00006] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was (1) to determine the coping strategies employed by spouses of patients with AMI in the early phase of the crisis, (2) to define the role of age, gender, health perception, time since infarction, spouses' fears, and negative life events in the choice of coping strategies applied, and (3) to test the effect of coping strategies on physical and psychological strain. Fifty-seven spouses participated in the study, 47 were female and 10 were male. Data were collected by structured questionnaires, which were distributed to the spouses from 2 weeks-4 months after the patient's AMI. The researchers found that age, negative life event during the last 12 months, time since infarction, and the spouse's fears influenced the choice of strategies. In the early stage of the crisis, positive reappraisal seems to be a strategy that increased physical strain. Spouses' need for social support in the early stage of the crisis is a factor for health care providers to bear in mind. Besides giving information, empathy, and understanding, health care personnel can try to assist spouses in their efforts to reappraise their situation.
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Affiliation(s)
- N Santavirta
- Department of Education, University of Helsinki, Finland.
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38
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Mårtensson J, Dracup K, Fridlund B. Decisive situations influencing spouses' support of patients with heart failure: a critical incident technique analysis. Heart Lung 2001; 30:341-50. [PMID: 11604976 DOI: 10.1067/mhl.2001.116245] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of this study was to describe decisive situations experienced by spouses of patients with heart failure that could potentially affect their ability to provide social support to the patient. METHODS A qualitative descriptive design with a critical incident technique was used. Twenty-three informants, 15 women and 8 men, who were spouses of patients with severe heart failure were strategically chosen to ensure maximal variation in sociodemographic data and experiences as a spouse. RESULTS Decisive situations influenced the experience of spouses of patients with heart failure in a manner that was either positive (involvement with others) or negative (feeling like an outsider). When spouses were given attention and treated like persons of value, they experienced involvement with others. In these cases, spouses had someone to turn to and were included in the physical care. In contrast, when spouses were kept at a distance by the patient, were socially isolated, and received insufficient support from children, friends, and health care professionals, they experienced feeling like an outsider. CONCLUSIONS By identifying spouses' experiences, health care professionals can assess which kind of specific interventions should be used to improve the life situation of the patient with heart failure and his or her spouse.
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Affiliation(s)
- J Mårtensson
- Department of Cardiology, Ryhov County Hospital, Jönköping, Sweden
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Lee D. Accompany the sick: a unique practice in Chinese hospitals by patients' relatives and friends. Contemp Nurse 2001; 10:136-41. [PMID: 11855104 DOI: 10.5172/conu.10.3-4.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is a practice commonly found in many Chinese hospitals called 'accompany the sick' (pei ban). It means that many patients' relatives or friends 'live' with patients in the hospital. Such practice can benefit patients in that the visitors are providing psychological support and carrying out some bedside nursing care to the patients. However, it also creates many problems to nurses and hospitals such as overcrowding, an over-demand of hospital resources, and maintaining quality care. There is no study of such practice. In order to gain better understanding of 'accompany the sick', its impact on nursing practice and nursing professional development, identifying the contributing factors of such practice is needed. This is an ethnographic case study of a public hospital in western China. The study has discovered a number of factors that contribute to the practice, such as the Chinese concept of duty of care, the geographic and economic situation, and the unique culture of nursing practice. This is a pilot study and the result of this study will contribute to further study in nurses' work in China.
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Affiliation(s)
- D Lee
- Health Service Unit, School of Human Services, Art and Multi Media, University of Technology, Sunbury Campus, Sunbury, Victoria
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Svedlund M, Axelsson I. Acute myocardial infarction in middle-aged women: narrations from the patients and their partners during rehabilitation. Intensive Crit Care Nurs 2000; 16:256-65. [PMID: 10922190 DOI: 10.1054/iccn.2000.1516] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to examine the meaning of lived experiences after an acute myocardial infarction (AMI) and being a partner to an afflicted woman, as it is narrated during rehabilitation. Nine women and their partners narrated their experiences three and twelve months after AMI. The interview texts were transcribed and then interpreted, using a phenomenological-hermeneutic method inspired by the philosophy of Ricoeur. The result showed that their experiences of the illness contained two themes: 'rehabilitation needed' and 'loss of freedom' which contains eight sub-themes; 'adapting to it', 'struggling against it', 'living as normally as possible', 'having insight into how it can be', 'feeling guilty and ashamed about being weak', 'withholding feelings', 'feeling useless', and 'feeling fatigued and losing strength'. After further interpretation, the themes gave a deeper meaning of living with AMI and how it affects women and their partners. The women conceded that they felt distressed and vulnerable but struggled against the fear the illness means. The partner's role appears to be one of trying to adapt to the women's experiences of the illness. That the women withheld their feelings and did not talk about them indicates a lack of communication between the couples. As coronary care nurses often come very close both to the afflicted persons and the relatives they fill an important function in each patient's recovery. The nurses could help and prepare the patients and their relatives to understand better such feelings and reactions as could appear after discharge from hospital.
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Affiliation(s)
- M Svedlund
- Department of Health Sciences, Mid Sweden University, Ostersund.
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