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Rosenstrøm S, Chou WX, Brødsgaard A. How Family Members Experienced a Family-Focused Atrial Fibrillation Intervention in an Outpatient Setting—A Qualitative Study. SAGE Open Nurs 2022; 8:23779608221114265. [PMID: 35938068 PMCID: PMC9350502 DOI: 10.1177/23779608221114265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/06/2022] [Accepted: 06/18/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction Family-focused nursing has gained ground worldwide, and a range of healthcare
systems are now practicing family-focused nursing, which has been shown to
increase the quality of care. Even so, a lack of research remains into
family-focused nursing for various groups of patients in clinical
practice. Objectives The purpose of this study was to explore how family members (FMs) of patients
with atrial fibrillation (AF) experienced a family-focused nursing
intervention in a clinical outpatient setting. Methods This was a qualitative phenomenological interview study employing Reflective
Lifeworld Research (RLR) to explore humans’ lived experiences. The data
reported herein were derived from semi-structured interviews with seven FMs
of patients with AF who participated in a clinical trial which tested a
family-focused intervention in a Cardiology outpatient clinic treating
patients with AF. The transcribed interviews were analyzed in four phases
which is an iterative process as proposed by Dahlberg and Dahlberg. Findings The essence of the phenomenon was experiencing less panic and finding peace,
which emerged from the following four patterns. (1) The FMs’ post-AF
experience, (2) Enhanced understanding and knowledge of AF, (3) Personal
interaction with a nurse specialist and (4) AF becomes manageable. A space
facilitating reflection upon the disease and daily life with the disease was
established through group sessions and family conversations. Conclusion A family-focused nursing intervention facilitated by specialized nurses with
extensive communication skills filled a knowledge gap related to AF thereby
reducing panic and increasing peace among FMs. Furthermore, the intervention
facilitated family awareness of their resources to bring about change,
regain balance, and enhance well-being in their everyday lives and initiated
a healing process in the families. Future interventions for patients with AF
should consider FMs as well as patients as an entity of care.
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Affiliation(s)
- Stine Rosenstrøm
- Department of Cardiology, Copenhagen University Hospital, Amager
Hvidovre, Capital Region of Denmark
- Nursing and Health Care, Department of Public Health, University of
Aarhus, Denmark
- Stine Rosenstrøm, Department of Cardiology,
Hvidovre Hospital, Kettegård Allé 30, 2650 Hvidovre, Capital Region of Denmark.
| | - Wan Xui Chou
- Department of Cardiology, Copenhagen University Hospital
Glostrup, Capital Region of Denmark
| | - Anne Brødsgaard
- Nursing and Health Care, Department of Public Health, University of
Aarhus, Denmark
- Department of Paediatrics and Adolescent Medicine, Copenhagen
University Hospital, Amager Hvidovre, Capital Region of Denmark
- Department of Obstetrics and Gynaecology, Copenhagen University
Hospital, Amager Hvidovre, Capital Region of Denmark
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Rosenstrøm S, Risom SS, Ejlertsen C, Hove JD, Brødsgaard A. Dancing with atrial fibrillation - How arrhythmia affects everyday life of family members: A qualitative study. PLoS One 2021; 16:e0254130. [PMID: 34228743 PMCID: PMC8259977 DOI: 10.1371/journal.pone.0254130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Patients with AF often experience debilitating symptoms, stress and reduced health-related quality of life. Previous qualitative research on AF has primarily focused on the patient. AF, however, can also be burdensome for the patient’s family. Aim The aim of this study was to explore how family members experience life when a close member in the family has AF. Method Transcribed focus group interviews were analysed using content analysis approach inspired by Graneheim and Lundman. Results Two focus group interviews were conducted with 11 family members. The overall theme was Dancing with AF. The theme emerged from three categories: 1)Handling AF as a living condition, 2) Influencing the roles of family members, 3) Fear of AF attack. AF had a very significant impact on the patients’ family members, forcing them to reconstruct their daily lives. Conclusions AF has multiple consequences for family members and can give rise to conflicts concerning family roles. Family members have a lack of knowledge of AF and fear of how AF can cause changes in the family members’ everyday lives. This study demonstrates that there is a need for further research of ways to support the family members of patients with AF.
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Affiliation(s)
- Stine Rosenstrøm
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
- * E-mail:
| | - Signe Stelling Risom
- Department of Cardiology, Herlev and Gentofte University Hospital, Hellerup, Denmark
- Institute of Nursing and Nutrition, University College, Copenhagen, Denmark
- Copenhagen University, Faculty of Health and Medical Sciences, Copenhagen, Denmark
| | - Camilla Ejlertsen
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
- Department of Gynecology and Obstetrics, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
| | - Jens Dahlgaard Hove
- Department of Cardiology, Copenhagen University Hospital, Amager Hvidovre, Hvidovre, Capital Region of Denmark
| | - Anne Brødsgaard
- Department of Public Health, Nursing and Health Care, University of Aarhus, Aarhus, Denmark
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Chang SL, Kuo MJ, Lin YJ, Chen SA, Chen CT, Yang YY, Yang LY, Kao SY, Shulruf B, Lee FY. Virtual reality-based preprocedural education increases preparedness and satisfaction of patients about the catheter ablation of atrial fibrillation. J Chin Med Assoc 2021; 84:690-697. [PMID: 34029219 DOI: 10.1097/jcma.0000000000000555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A recent study suggested to develop and implement more interacted material for preprocedural education to decrease patients' anxiety about the atrial fibrillation (AF) ablation. This study compared the effectiveness of using either newly developed virtual reality (VR) materials (VR group) or paper-based materials (paper group) on giving AF preprocedural education. METHODS This study consequentially enrolled 33 AF patients preparing for ablation from November 2019 to October 2020. After enrollment, patients were randomized as either paper (n = 22) or VR (n = 11) groups. RESULTS In comparison with the baseline stage, at the posteducation stage, the degree of improvement in patients' self-assessed self-efficacy on AF ablation knowledge was higher among VR group patients than those in the paper group. At the posteducation stage, the patients' satisfaction to preprocedural education and used materials were higher among the VR group than that among the paper group. In addition to meet their needs and give accurate medical information, VR group patients reported that VR materials increased the effectiveness of education, increased their preparedness for AF catheter ablation, achieved paperless purposes, and willing to recommend VR materials to others. Operators subjectively reported that the periprocedure cooperation was increased both among paper and VR group patients after preprocedural education for the details of procedure. Better preparedness of VR group patients was supported by less periprocedure pain, anxiety, and impatience than those among paper group patients. CONCLUSION Interactive VR-based materials are superior to the paper-based materials to provide patients immerse and imagine the journey and detail knowledge of AF catheter ablation before the procedure and better prepared patients for the procedure.
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Affiliation(s)
- Shih-Lin Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ming-Jen Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Shih-Ann Chen
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Chung-Ting Chen
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | | | - Fa-Yauh Lee
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Chang SL, Kuo MJ, Lin YJ, Chen SA, Yang YY, Cheng HM, Yang LY, Kao SY, Lee FY. Virtual reality informative aids increase residents' atrial fibrillation ablation procedures-related knowledge and patients' satisfaction. J Chin Med Assoc 2021; 84:25-32. [PMID: 33230060 DOI: 10.1097/jcma.0000000000000464] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is the most common cardiac arrhythmia, and increasing numbers of patients receive AF ablation nowadays. Therefore, in the cardiology division, residents need to be familiar with the AF ablation procedure-related knowledge for primary care. This study evaluated the baseline residents and patients' self-efficacy to the AF ablation procedure-related knowledge, developed the specific virtual reality (VR) informative aids, and evaluated the effects of VR training and resident-led VR aids-based patient education on their self-efficacy, in the aspects of familiarity, confidence and anxiety, and satisfaction. METHODS From 2019, April to 2020, April, this 1-year prospective prestudy and poststudy was undergone in the cardiology division. Between 2019, April and 2019, December, the experienced physicians were invited to develop VR informative aids for AF ablation procedure-related knowledge. Between January 2020 and April 2020, newly developed VR informative aids were implemented in the educational program of training rotated residents for giving patient education. RESULT A total of 20 residents and 32 patients were enrolled. The baseline self-reported self-efficacy and knowledge scores were relatively low among rotated residents and their patients. In addition to the high level of satisfaction, self-efficacy and knowledge scores of residents and their patients were increased after VR aids-based training and resident-led patient education. Higher degree of improvement in self-efficacy was noted among patients with depression/anxiety history than those without history. The follow-up assessments among residents showed that the positive effects of VR aids were sustained until 2 weeks later. CONCLUSION Overall, residents and patients reported that the VR aids increase the effectiveness of patient education, achieve the purpose of a paperless environment, and motivate them to recommend it to others. The implementation of resident-to-patient education has a positive impact on trainees and patients understanding about AF ablation procedures-related knowledge.
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Affiliation(s)
- Shih-Lin Chang
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Ming-Jen Kuo
- Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shih-Ann Chen
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ying-Ying Yang
- Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Division of Clinical Skills Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Hao-Min Cheng
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Ling-Yu Yang
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shou-Yen Kao
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fa-Yauh Lee
- Vice Superintendent, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
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Pelto-Piri V, Warg LE, Kjellin L. Violence and aggression in psychiatric inpatient care in Sweden: a critical incident technique analysis of staff descriptions. BMC Health Serv Res 2020; 20:362. [PMID: 32336265 PMCID: PMC7184692 DOI: 10.1186/s12913-020-05239-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 04/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Violence towards staff working in psychiatric inpatient care is a serious problem. The aim of the present study was to explore staff perspectives of serious violent incidents involving psychiatric inpatients through the following research questions: Which factors contributed to violent incidents, according to staff? How do staff describe their actions and experiences during and after violent incidents? METHODS We collected data via a questionnaire with open-ended questions, and captured 283 incidents reported by 181 staff members from 10 inpatient psychiatric wards in four different regions. We used the Critical Incident Technique to analyse the material. Our structural analysis started by structuring extracts from the critical incidents into descriptions, which were grouped into three chronological units of analyses: before the incident, during the incident and after the incident. Thereafter, we categorised all descriptions into subcategories, categories and main areas. RESULTS Staff members often attributed aggression and violence to internal patient factors rather than situational/relational or organisational factors. The descriptions of violent acts included verbal threats, serious assault and death threats. In addition to coercive measures and removal of patients from the ward, staff often dealt with these incidents using other active measures rather than passive defence or de-escalation. The main effects of violent incidents on staff were psychological and emotional. After violent incidents, staff had to continue caring for patients, and colleagues provided support. Support from managers was reported more rarely and staff expressed some dissatisfaction with the management. CONCLUSIONS As a primary prevention effort, it is important to raise awareness that external factors (organisational, situational and relational) are important causes of violence and may be easier to modify than internal patient factors. A secondary prevention approach could be to improve staff competence in the use of de-escalation techniques. An important tertiary prevention measure would be for management to follow up with staff regularly after violent incidents and to increase psychological support in such situations.
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Affiliation(s)
- Veikko Pelto-Piri
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Lars-Erik Warg
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Lars Kjellin
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Stridsman M, Strömberg A, Hendriks J, Walfridsson U. Patients' Experiences of Living with Atrial Fibrillation: A Mixed Methods Study. Cardiol Res Pract 2019; 2019:6590358. [PMID: 31885904 PMCID: PMC6915031 DOI: 10.1155/2019/6590358] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 09/24/2019] [Accepted: 10/26/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Awareness of epidemiological and clinical consequences of atrial fibrillation (AF) has increased, as have disease-related costs. Less attention has been paid to patient-related issues, such as understanding how symptoms, different therapies, and lifestyle adjustments affect daily life. We aimed to describe patients' experiences of living with AF. METHODS The study design used a parallel convergent mixed methods approach. Patients with AF were included in the SMURF study and referred for catheter ablation. Patients completed questionnaires on symptoms, health-related quality of life, depression, anxiety, and perceived control and were interviewed. The datasets were analysed separately using inductive content analysis and descriptive statistics. Data were merged to obtain a final interpretation. RESULTS Nineteen patients were interviewed and 18 completed questionnaires. Twelve of the patients were male, mean age 60 years (45-75 years). Inductive qualitative analysis revealed three categories: (i) symptoms and concerns limiting life, (ii) dimensions of worries, and (iii) strategies for management. The most common symptoms were tiredness, weakness/fatigue, and breathlessness during activities, and the most pronounced negative impacts on health-related quality of life (HRQOL) were physically related, shown in the ASTA questionnaire. The most negative SF-36 scores were found in role limitations due to physical health problems and vitality. HADS revealed five patients with some degree of anxiety and four with some degree of depression. Patients had lower scores on perceived control than perceived helplessness in CAS. Patients' perceived control was higher than their families', and families experienced more helplessness. CONCLUSIONS The mixed methods design deepens our understanding of challenges faced by patients. Patients experienced a limited ability to perform activities of daily living due to AF which created different kinds of worries that encouraged the use of various strategies to manage their lives. Healthcare providers need to be aware that relationships between patients and their relatives can change, and therefore they need to be supported and integrated into the care system.
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Affiliation(s)
| | - Anna Strömberg
- Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Jeroen Hendriks
- Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
- Centre for Heart Rhythm Disorders, University of Adelaide, South Australian Health & Medical Research Institute and Royal Adelaide Hospital, Adelaide, Australia
| | - Ulla Walfridsson
- Department of Medical and Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
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Bergtun S, Oterhals K, Fridlund B. Patients’ experiences 1-6 months after atrial fibrillation ablation: An holistic perspective. J Adv Nurs 2018; 75:150-160. [DOI: 10.1111/jan.13843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/26/2018] [Accepted: 08/17/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Sønneva Bergtun
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
- Western Norway University of Applied Sciences; Bergen Norway
| | - Kjersti Oterhals
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
- Western Norway University of Applied Sciences; Bergen Norway
| | - Bengt Fridlund
- Department of Heart Disease; Haukeland University Hospital; Bergen Norway
- Western Norway University of Applied Sciences; Bergen Norway
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Malm D, Fridlund B, Ekblad H, Karlström P, Hag E, Pakpour AH. Effects of brief mindfulness-based cognitive behavioural therapy on health-related quality of life and sense of coherence in atrial fibrillation patients. Eur J Cardiovasc Nurs 2018; 17:589-597. [PMID: 29493266 DOI: 10.1177/1474515118762796] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effects of a brief dyadic cognitive behavioural therapy (CBT) programme on the health-related quality of life (HRQoL), as well as the sense of coherence in atrial fibrillation patients, up to 12 months post atrial fibrillation. METHODS A longitudinal randomised controlled trial with a pre and 12-month post-test recruitment of 163 persons and their spouses, at a county hospital in southern Sweden. In all, 111 persons were randomly assigned to either a CBT ( n=56) or a treatment as usual (TAU) group ( n=55). The primary outcome was changes in the HRQoL (Euroqol questionnaire; EQ-5D), and the secondary outcomes were changes in psychological distress (hospital anxiety and depression scale; HADS) and sense of coherence (sense of coherence scale; SOC-13). RESULTS At the 12-month follow-up, the CBT group experienced a higher HRQoL than the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group -0.015; P=0.02). The sense of coherence improved in the CBT group after the 12-month follow-up, compared to the TAU group (mean changes in the CBT group 0.062 vs. mean changes in the TAU group -0.16; P=0.04). The association between the intervention effect and the HRQoL was totally mediated by the sense of coherence ( z=2.07, P=0.04). CONCLUSIONS A dyadic mindfulness-based CBT programme improved HRQoL and reduced psychological distress up to 12 months post atrial fibrillation. The sense of coherence strongly mediated the HRQoL; consequently, the sense of coherence is an important determinant to consider when designing programmes for atrial fibrillation patients.
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Affiliation(s)
- Dan Malm
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Bengt Fridlund
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Helena Ekblad
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Patric Karlström
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Emma Hag
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,2 Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Amir H Pakpour
- 1 School of Health and Welfare, Jönköping University, Jönköping, Sweden.,3 Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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9
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Dalteg T, Sandberg J, Malm D, Sandgren A, Benzein E. The heart is a representation of life: an exploration of illness beliefs in couples living with atrial fibrillation. J Clin Nurs 2017; 26:3699-3709. [PMID: 28122413 DOI: 10.1111/jocn.13742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2017] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To explore illness beliefs in couples where one spouse has atrial fibrillation. BACKGROUND Beliefs are the lenses through which we view the world, guiding our behaviour and constructing our lives. Couples evolve an ecology of beliefs from their interaction whereby their actions and choices arise from their beliefs. Atrial fibrillation is a common cardiac arrhythmia that has implications for both patients and partners. A couple's illness beliefs play an important role in convalescence and illness management, and no previous studies have explored illness beliefs in couples living with atrial fibrillation. DESIGN A qualitative hermeneutic design. METHODS Data collection constituted in-depth interviews with nine couples (patient and partner together). Hermeneutic philosophy as described by Gadamer was used to interpret and to understand illness beliefs in couples living with atrial fibrillation. RESULTS The findings revealed both core illness beliefs and secondary illness beliefs. From the core illness belief 'The heart is a representation of life', two secondary illness beliefs were derived: atrial fibrillation is a threat to life and atrial fibrillation can and must be explained. From the core illness belief 'Change is an integral part of life', two secondary illness beliefs were derived: atrial fibrillation is a disruption in our lives and atrial fibrillation will not interfere with our lives. Finally, from the core illness belief 'Adaptation is fundamental in life', two secondary illness beliefs were derived: atrial fibrillation entails adjustment in daily life and atrial fibrillation entails confidence in and adherence to professional care. CONCLUSION Couples' interaction has developed mutual illness beliefs regarding atrial fibrillation that guide them in their daily lives and influence their decisions. The adoption of a family-centred perspective in cardiovascular care settings is warranted.
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Affiliation(s)
- Tomas Dalteg
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jonas Sandberg
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Dan Malm
- School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Anna Sandgren
- The Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden.,Department of Health and Care Sciences, Linnaeus University, Kalmar, Sweden
| | - Eva Benzein
- The Center for Collaborative Palliative Care, Linnaeus University, Växjö, Sweden.,Department of Health and Care Sciences, Linnaeus University, Kalmar, Sweden
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Eriksson K, Wikström L, Fridlund B, Årestedt K, Broström A. Patients' experiences and actions when describing pain after surgery--a critical incident technique analysis. Int J Nurs Stud 2015; 56:27-36. [PMID: 26772655 DOI: 10.1016/j.ijnurstu.2015.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/18/2015] [Accepted: 12/21/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Postoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients' experiences and actions could help healthcare professionals to improve pain management and could increase patients' participation in pain assessments. OBJECTIVE The aim of this study was, through an examination of critical incidents, to describe patients' experiences and actions when needing to describe pain after surgery. METHODS An explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. FINDINGS Pain experiences were described according to two main areas: "Patients' resources when in need of pain assessment" and "Ward resources for performing pain assessments". Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients' ability to describe pain. Two main areas regarding actions emerged: "Patients used active strategies when needing to describe pain" and "Patients used passive strategies when needing to describe pain". Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals' large work load.
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Affiliation(s)
- Kerstin Eriksson
- School of Health Sciences, Jönköping University, PO Box 1026, 551 11 Jönköping, Sweden; Department of Anaesthesia and Intensive Care, Ryhov County Hospital, 551 85 Jönköping Sweden.
| | - Lotta Wikström
- School of Health Sciences, Jönköping University, PO Box 1026, 551 11 Jönköping, Sweden; Department of Anaesthesia and Intensive Care, Ryhov County Hospital, 551 85 Jönköping Sweden
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, PO Box 1026, 551 11 Jönköping, Sweden.
| | - Kristofer Årestedt
- School of Health and Caring Sciences, Linnaeus University, 391 82 Kalmar, Sweden; Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, 581 83 Linköping, Sweden; Department of Clinical Neurophysiology, University Hospital, 581 85 Linköping, Sweden.
| | - Anders Broström
- School of Health Sciences, Jönköping University, PO Box 1026, 551 11 Jönköping, Sweden; Department of Clinical Neurophysiology, University Hospital, 581 85 Linköping, Sweden.
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