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- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
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Myocardial infarction : gender differences in coping and social support
- 2003
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 44:4, s. 360-374
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction.Rationale. Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception of recovery after cardiac events. No review has been found which focuseson gender differences in coping and social support in myocardial infarction patients.Method. A computerized search was conducted using the keywords ‘myocardial infarction’, ‘coping’, ‘gender differences’ and ‘social support’. Forty-one articles, published between 1990 and October 2002, were scrutinized.Findings. Two studies report that women used more coping strategies than men. Several qualitative studies found that women used a variety of coping strategies. Women minimized the impact of the disease, tended to delay in seeking treatmentand did not want to bother others with their health problems. Household activities were important to them and aided their recovery. Men were more likely to involve their spouses in their recovery, and resuming work and keeping physically fit wereimportant to them. Women tended to report that they had less social support up to 1 year after a myocardial infarction compared with men. They received less informationabout the disease and rehabilitation and experienced lack of belief in their heart problems from caregivers. Further, they received less assistance with household duties from informal caregivers. Men tended to report more support from theirspouses than did women.Conclusions. Traditional gender-role patterns may influence the recovery of patients who have experienced myocardial infarction. Caregivers may need to be more sensitive to gender-specific needs with regard to risk profiles, social roles, and the patient’s own role identity. For many women, especially older ones, household duties and family responsibilities may be an opportunity and a base for cardiac rehabilitation.
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- Löfmark, Rurik
(författare)
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Do-not-resuscitate orders Ethical aspects on decision making and communication among physicians, nurses, patients and relatives
- 2001
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The purpose was to describe ethical aspects on how do-not-resuscitate (DNR) deci-sions are made, established, and communicated between physicians, nurses, patients and relatives. A random sample of 220 physicians and nurses answered a questionnaire about their attitudes to and experiences of the making and communication of a DNR decision. The re-sponse rate was 73%. Twenty seriously ill patients, and 21 relatives of patients who died with a DNR order, were interviewed. The literature on medical futility was searched for conditions for futility and moral consequences. The results showed that many physicians and nurses are uncertain about the rules and ethics of DNR orders. There are discrepancies between guidelines and attitudes regarding DNR orders, as well as between attitudes and behaviour. Seriously ill patients estimate open and straightforward conversations about treatments in the end of life. Relatives seem to get acceptable information and counselling. Conditions and consequences of medical futility may be approached in a new clinical way. There are numerous possible ethical conflicts within and between the principles of autonomy, non-maleficence, beneficence, and the virtues and ideals of the profession. Start a dialogue about end-of-life support with chronically ill and elderly patients, and their relatives, while they still are capable of understanding and authorisation. The clinical conversation model may make it easier. All involved should understand why certain deci-sions are made. Conditions and consequences of futility should be ascertained together with the patients, the relatives and the staff, after which a joint decision can be reached.
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