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Sutantri S, Cuthill F, Holloway A. "I just can't sit around and do nothing!": A qualitative study of Indonesian women's experiences diagnosed with heart disease. Nurs Health Sci 2020; 22:1047-1055. [PMID: 32713133 DOI: 10.1111/nhs.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Abstract
Research into cardiovascular disease and its management in Indonesia, where it currently accounts for 67% of all deaths, has heavily emphasized the biomedical aspects; little is known about the individual's experience of the disease, especially for Indonesian women. This study aimed to understand how gender shapes Indonesian women's experiences of living with heart disease in their daily lives. Twenty-six women aged 30-67 years were interviewed, and the transcriptions analyzed using a qualitative framework informed by intersectional approaches to gender and culture. Three major themes emerged: (i) the effect of cardiovascular disease on women's day-to-day activities, (ii) its effects on women's family relationships, and (iii) the women's coping strategies. The inability to fulfill their required social roles as mother or wife undermined the women's sense of self, a problem particularly acute in a cultural context where responsibility for maintaining harmony in the home and society is ascribed to women. Healthcare professionals should be aware of the ethnic and cultural backgrounds of women with cardiovascular disease, in order to deliver services that meet female patients' social, spiritual, and cultural needs.
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Affiliation(s)
- Sutantri Sutantri
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Jln. Brawijaya, Tamantirto, Kasihan, Bantul, Yogyakarta, Indonesia.,Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Fiona Cuthill
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
| | - Aisha Holloway
- Department of Nursing Studies, School of Health in Social Science, The University of Edinburgh, Medical School, Edinburgh, UK
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Wieslander I, Mårtensson J, Fridlund B, Svedberg P. Women's experiences of how their recovery process is promoted after a first myocardial infarction: Implications for cardiac rehabilitation care. Int J Qual Stud Health Well-being 2016; 11:30633. [PMID: 27172514 PMCID: PMC4864844 DOI: 10.3402/qhw.v11.30633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND A rapid improvement in the care of myocardial infarction (MI) in the emergency services has been witnessed in recent years. There is, however, a lack of understanding of the factors involved in a successful recovery process, after the initial stages of emergency care among patients, and in particular those who are women. Both preventive and promotive perspectives should be taken into consideration for facilitating the recovery process of women after a MI. AIM To explore how women's recovery processes are promoted after a first MI. METHODS A qualitative content analysis was used. FINDINGS The women's recovery process is a multidirectional process with a desire to develop and approach a new perspective on life. The women's possibility to approach new perspectives on life incorporates how they handle the three dimensions: behaviour, that is, women's acting and engaging in various activities; social, that is, how women receive and give support in their social environment; and psychological, that is, their way of thinking, reflecting, and appreciating life. CONCLUSIONS The personal recovery of women is a multidirectional process with a desire to develop and approach a new perspective on life. It is important for cardiac rehabilitation nurses to not only focus on lifestyle changes and social support but also on working actively with the women's inner strength in order to promote the recovery of the women.
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Affiliation(s)
- Inger Wieslander
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
- School of Health Sciences, Jönköping University, Jönköping, Sweden;
| | - Jan Mårtensson
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Petra Svedberg
- School of Social and Health Sciences, Halmstad University, Halmstad, Sweden
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Galick A, D'Arrigo-Patrick E, Knudson-Martin C. Can Anyone Hear Me? Does Anyone See Me? A Qualitative Meta-Analysis of Women's Experiences of Heart Disease. QUALITATIVE HEALTH RESEARCH 2015; 25:1123-1138. [PMID: 25924615 DOI: 10.1177/1049732315584743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Female heart patients are underdiagnosed and undertreated. The purpose of this qualitative meta-data-analysis was to explain how societal expectations related to gender and the treatment environment influence women's experiences and can inform optimal care. The authors used grounded theory methodology and a social constructionist gender lens to analyze 43 studies (1993-2012) of women's experiences of heart disease. The analysis illustrates how social expectations within both medical and relational contexts led to women experiencing barriers to diagnosis and treatment and inadvertent minimization of their experience and knowledge. Women's descriptions of their experiences suggest three kinds of health care strategies that have the potential to increase women's engagement with heart disease treatment and rehabilitation: (a) support give and take in relational connections, (b) identify and acknowledge unique health-promoting behavior, and (c) focus on empowerment. These findings have interdisciplinary implications for practice with women with heart disease.
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Affiliation(s)
- Aimee Galick
- University of Louisiana at Monroe, Monroe, Louisiana, USA
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Uren A, Galdas P. The experiences of male sudden cardiac arrest survivors and their partners: a gender analysis. J Adv Nurs 2014; 71:349-58. [PMID: 25092134 DOI: 10.1111/jan.12499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2014] [Indexed: 11/30/2022]
Abstract
AIM To explore how masculinities shape the experiences of men and their partners after survival from out-of-hospital cardiac arrest. BACKGROUND Survivors of out-of-hospital cardiac arrest report depression, dependence on others for daily functioning, decreased participation in society and significant decreases in quality of life. There is growing evidence that masculine gender identities play a central role in the recovery experiences of men and their families following other major cardiac events. However, to date, there has been no examination of how masculinities shape men's experiences of recovery following out-of-hospital cardiac arrest. DESIGN Interview study guided by an interpretive description approach. Data were subjected to thematic analysis. METHOD A purposive sample of seven male sudden cardiac arrest survivors and 6 female partners was recruited in 2010 from a secondary care centre in British Columbia, Canada. RESULTS Three themes were prominent in the experiences of the participants: (1) Support and self-reliance; (2) Dealing with emotional (in) vulnerability; and (3) No longer a 'He-man'. CONCLUSION Masculinities played a role in men's experiences of recovery and adaptation following out-of-hospital cardiac arrest. Hegemonic masculinity partly explained men's experiences, notably their reluctance to seek professional support and reactions to changes in lifestyle. However, the study also suggests that the popular stereotype of men being 'strong and silent' in the face of ill-health may only be a part of a more complex story. Nurses would benefit from taking into consideration the potential influence of male gender identities on men's recovery postcardiac arrest.
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Affiliation(s)
- Alan Uren
- Bristol Urological Institute, North Bristol NHS Trust, UK
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Levack WMM. The role of qualitative metasynthesis in evidence-based physical therapy. PHYSICAL THERAPY REVIEWS 2013. [DOI: 10.1179/1743288x12y.0000000020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- William M M Levack
- Rehabilitation Teaching & Research UnitDepartment of Medicine, University of Otago, Wellington, New Zealand
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Najafi Ghezeljeh T, Yadavar Nikravesh M, Emami A. Coronary heart disease patients transitioning to a normal life: perspectives and stages identified through a grounded theory approach. J Clin Nurs 2013; 23:571-85. [PMID: 24175915 DOI: 10.1111/jocn.12272] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore how Iranian patients with coronary heart disease experience their lives. BACKGROUND Coronary heart disease is a leading cause of death in Iran and worldwide. Understanding qualitatively how patients experience the acute and postacute stages of this chronic condition is essential knowledge for minimising the negative consequences of coronary heart disease. DESIGN Qualitative study using grounded theory for the data analysis. METHODS Data for this study were collected through individual qualitative interviews with 24 patients with coronary heart disease, conducted between January 2009 and January 2011. Patients with angina pectoris were selected for participation through purposive sampling, and sample size was determined by data saturation. Data analysis began with initial coding and continued with focused coding. Categories were determined, and the core category was subsequently developed and finalised. RESULTS The main categories of the transition from acute phase to a modified or 'new normal' life were: (1) Loss of normal life. Experiencing emotions and consequences of illness; (2) Coming to terms. Using coping strategies; (3) Recreating normal life. Healthcare providers must correctly recognise the stages of transition patients navigate while coping with coronary heart disease to support and educate them appropriately throughout these stages. CONCLUSION Patients with coronary heart disease lose their normal lives and must work towards recreating a revised life using coping strategies that enable them to come to terms with their situations. RELEVANCE TO CLINICAL PRACTICE By understanding Iranian patients' experiences, healthcare providers and especially nurses can use the information to support and educate patients with coronary heart disease on how to more effectively deal with their illness and its consequences.
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Affiliation(s)
- Tahereh Najafi Ghezeljeh
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran; Department of Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
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Son H, Thomas SA, Friedmann E. Longitudinal Changes in Coping for Spouses of Post–Myocardial Infarction Patients. West J Nurs Res 2013; 35:1011-25. [DOI: 10.1177/0193945913484814] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spouses are the key in the recovery and coping of patients after a myocardial infarction (MI). The purpose of this study was to examine changes in coping for spouses of post-MI patients over time. The study determined the contributions of a spouse’s demographic factors and of time since the MI to the changes in coping. A secondary data analysis from the Patients’ and Families’ Psychological Response to Home Automated External Defibrillator Trial was conducted. On average, older spouses coped better than younger spouses. Coping significantly decreased over time. The spouse’s coping decreased for spouses whose baseline coping was higher. Coping decreased more rapidly for spouses of patients who experienced an MI more recently. Patients and spouses need support to improve coping after an MI.
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Affiliation(s)
| | - Sue A. Thomas
- University of Maryland School of Nursing, Baltimore, USA
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Exploring Nurses’ Perceptions of Providing Sexual Health Counseling for Patients With Cardiac Disease. Dimens Crit Care Nurs 2013; 32:191-8. [DOI: 10.1097/dcc.0b013e31829980d1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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Coping Experiences: A Pathway towards Different Coping Orientations Four and Twelve Months after Myocardial Infarction-A Grounded Theory Approach. Nurs Res Pract 2012; 2012:674783. [PMID: 23304483 PMCID: PMC3523568 DOI: 10.1155/2012/674783] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 09/21/2012] [Accepted: 10/19/2012] [Indexed: 12/05/2022] Open
Abstract
Background. Patients recovering from a myocardial infarction (MI) are faced with a number of serious challenges. Aim. To create a substantive theory on myocardial infarction patients' coping as a continuum. Methods. Grounded theory method was used. Data were collected by using individual interviews. The informants were 28 MI patients. Results. The core category “coping experiences—a pathway towards different coping orientations” includes 2 main categories: “positive and negative coping experiences” (4 months after MI) and “different coping orientations” (12 months after MI). Conclusion. Coping with a myocardial infarction is a long-term dynamic process of dealing with varied emotions and adjustment needs. Coping is threatened, if the patient denies the seriousness of the situation, suffers from depression and emotional exhaustion, or if there are serious problems in the interaction with family members. This study stresses the importance of recognizing the patient's depressive state of mind and the psychological aspects which affect family dynamics. A more family-centered approach involving a posthospital counseling intervention is recommended. Relevance to Clinical Practice. The results of this study can be used in nursing care practice when organizing support interventions for myocardial infarction patients.
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Mutsonziwa GA, Green J. Colonised and isolated: a qualitative metasynthesis of patients’ experiences of being infected with multiple drug resistant organisms and subsequent isolation. ACTA ACUST UNITED AC 2011. [DOI: 10.1071/hi11020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kendel F, Dunkel A, Müller-Tasch T, Steinberg K, Lehmkuhl E, Hetzer R, Regitz-Zagrosek V. Gender differences in health-related quality of life after coronary bypass surgery: results from a 1-year follow-up in propensity-matched men and women. Psychosom Med 2011; 73:280-5. [PMID: 21364199 DOI: 10.1097/psy.0b013e3182114d35] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine whether the predictive value of gender for health-related quality of life (HRQoL) is independent of clinical health status and depression. Women undergoing coronary bypass surgery generally report a poorer HRQoL than men. METHODS A total of 990 (20% women) patients completed study questionnaires 1 day before coronary bypass surgery and 1 year after surgery. Physical aspects of HRQoL were assessed with the Short Form 36 Health Survey. Depression was measured with the self-reported Patient Health Questionnaire. Propensity score matching was applied to match men and women with respect to 65 clinical variables. Of 198 women, 157 (79.3%) could be matched to a partner, resulting in an excellent balance of clinical variables between the matched groups. RESULTS At baseline, propensity-matched men and women differed in physical functioning (p < .001) and role functioning (p = .007), but not in bodily pain and general health perception. In both men and women, HRQoL outcomes improved over 1 year. Preoperative depression predicted worse physical HRQoL in all outcomes, except general health perception 1 year after surgery. After adjusting for depression, gender lost its predictive power with respect to physical functioning. However, compared with women, men still reported a better role functioning. CONCLUSION Our data suggest that gender is a marker for role functioning, independent of the clinical health status and depression. Rehabilitation measures designed for the specific needs of women might help to improve their HRQoL.
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Affiliation(s)
- Friederike Kendel
- Institut für Medizinische Psychologie, Charité Centrum 1 für Human- und Gesundheitswissenschaften, Charité-Universitätsmedizin Berlin, Luisenstraße 57, 10117 Berlin, Germany.
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Eriksson M, Asplund K, Svedlund M. Couples' thoughts about and expectations of their future life after the patient's hospital discharge following acute myocardial infarction. J Clin Nurs 2010; 19:3485-93. [PMID: 21029224 DOI: 10.1111/j.1365-2702.2010.03292.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To describe and interpret couples' thoughts and expectations about their future life after the patient's discharge following acute myocardial infarction. BACKGROUND An acute myocardial infarction is a challenge for both the patient and his/her partner, as it can disrupt family functioning and dynamics. Earlier research has generally focused on either the patient or the partner, and few studies have explored the experiences of the couple. DESIGN Qualitative descriptive and interpretative. METHODS Fifteen couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed in two phases using qualitative content analysis. RESULTS The first phase of the analysis revealed two categories: 'an active approach to the future' and 'a wait-and-see approach to the future', both of which described the participants' thoughts about the future. In the second phase, the couples' stories were interpreted and grouped into four positions: 'the life companions', 'the tightrope walkers', 'the pathfinders' and 'the observers', which illustrated their visions of the future. CONCLUSIONS Our results reveal differences in the couples' thoughts about and expectations of their future life, most of them managed the situation by having a positive attitude to life and their future. The couples discovered their resources and compensated for or balanced each other in the early recovery period. RELEVANCE TO CLINICAL PRACTICE The results indicate the importance of giving both partners the opportunity to express their views of the situation, as this increases nurses' understanding of the impact of the illness on their life and relationship. However, the results also highlight the significance of seeing the couple and showing them consideration both as individuals and as a unit.
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Affiliation(s)
- Monica Eriksson
- Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
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Kendel F, Dunkel A, Lehmkuhl E, Hetzer R, Regitz-Zagrosek V. Does Time Spent on Household Activities or Housework Stress Complicate Recovery Following Coronary Artery Bypass Surgery? Women Health 2008; 48:325-38. [DOI: 10.1080/03630240802463525] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Friederike Kendel
- a Institute for Medical Psychology, Charité–Universitätsmedizin , Berlin , Germany
| | - Anne Dunkel
- b Berlin Institute of Gender in Medicine (GiM), Charité–Universitätsmedizin , Berlin , Germany
| | - Elke Lehmkuhl
- c Deutsches Herzzentrum Berlin (German Heart Institute) and the Berlin Institute of Gender in Medicine (GiM), Charité–Universitätsmedizin , Berlin , Germany
| | - Roland Hetzer
- d Deutsches Herzzentrum Berlin (German Heart Institute) , Germany
| | - Vera Regitz-Zagrosek
- b Berlin Institute of Gender in Medicine (GiM), Charité–Universitätsmedizin , Berlin , Germany
- e Deutsches Herzzentrum Berlin and the Center for Cardiovascular Research (CCR), Charité–Universitätsmedizin , Berlin , Germany
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