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- Brännström, Margareta, et al.
(författare)
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Being a close relative of a person with severe, chronic heart failure in palliative advanced home care : a comfort but also a strain
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 21:3, s. 338-344
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Tidskriftsartikel (refereegranskat)abstract
- Within previous research on family care of terminally ill people, studies have only rarely been carried out concerning heart failure care. This study aims to illuminate meanings of being a close relative of a person with severe, chronic heart failure (CHF) in palliative advanced home care (PAHC). Narrative interviews were conducted with three close relatives, tape-recorded, transcribed verbatim and a phenomenological-hermeneutic method was used to interpret the text. Meanings of being a close relative is to follow the life-threatening ups and downs, the person with CHF is going through. This means being on primary call, always on standby to mediate security and pleasure. In the deepest downs it is also to call for the back-up call i.e. the PAHC team, trusting their ability to show up on time to alleviate in the worst downs i.e. ease suffering. This study reveals that to be the close relative that the ill person is dependent on 24 hours a day is both a comfort and a strain.
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| 2. |
- Brännström, Margareta, et al.
(författare)
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Living with severe chronic heart failure in palliative advanced home care.
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 5:4, s. 295-302
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Living with severe chronic heart failure (CHF) in palliative care has been little studied. AIM: The aim of this study is to illuminate meaning of living with severe CHF in palliative advanced home care through patients' narratives. METHODS: Narrative interviews were conducted with 4 patients, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text. RESULTS: Meaning of living with severe CHF in palliative advanced home care emerged as 'knocking on death's door' although surviving. The course of the illness forces one to live a 'roller coaster life,' with an ongoing oscillation between ups and downs. Making it through the downs breeds a kind of confidence in one's ability to survive and the will to live is strong. Being offered a safety belt in the 'roller coaster' by the palliative advanced home care team evokes feelings of security. CONCLUSIONS: Meaning of living with severe CHF in palliative advanced home care is on one hand, being aware of one's imminent death, on the other hand, making it through the downs i.e. surviving life-threatening conditions, breed confidence in also surviving the current down. Being constructively dependent on palliative advanced home care facilitates everyday life at home.
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| 5. |
- Ekman, Inger, 1952, et al.
(författare)
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Gender makes a difference in the description of dyspnoea in patients with chronic heart failure.
- 2005
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Ingår i: Eur J Cardiovasc Nurs. - : Oxford University Press (OUP). - 1474-5151. ; 4:2, s. 117-21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dyspnoea is a common symptom of chronic heart failure (CHF). In the community setting, patients with CHF are most often women. Aim: To examine the impact of gender on the description of dyspnoea and to explore which clinical variables support a diagnosis of CHF. Methods: From four primary health care centres, 158 patients with CHF were included. Patients were examined with echocardiography and a cardiologist assessed the diagnosis of CHF. The patients filled in a questionnaire containing 11 descriptors of dyspnoea. Results: A diagnosis of CHF was confirmed in 87 (55%) patients (47 males and 40 females). One descriptor, I feel that I am suffocating, was significantly scored higher in CHF patients ( p=0.014) as compared to non-CHF patients. Three descriptors, My breath does not go in all the way ( p=0.006), I feel that I am suffocating ( p=0.040), and I cannot get enough air ( p=0.0327) were significantly scored higher among men with CHF, compared to no descriptor among women with CHF. Being male (OR=2.7; CI: 1.3–5.6, p=0.008), having diabetes (OR=5.6; CI: 1.7–18.2, p=0.004), IHD (OR=3.3; CI: 1.3–8.5, p=0.014), and a borderline significance for age (OR=1.04; CI: 0.99–1.08, p=0.058) predicted a confirmed diagnosis of CHF. Conclusion: Three descriptors of dyspnoea were associated with CHF among men, whereas no such association was found among women. Our results suggest that gender is an important factor and should—together with age, underlying heart disease, and diabetes—be taken into account when symptoms are evaluated in the diagnosis of CHF in primary care.
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| 6. |
- Ekman, Inger, 1952, et al.
(författare)
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Measuring shortness of breath in heart failure (SOB-HF): development and validation of a new dyspnoea assessment tool
- 2011
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Ingår i: European journal of heart failure. - : Wiley. - 1388-9842 .- 1879-0844. ; 13:8, s. 838-45
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Tidskriftsartikel (refereegranskat)abstract
- Aim To validate a previously developed instrument for measurement of breathlessness in patients with acute heart failure (HF). METHODS AND RESULTS: We tested descriptors of breathlessness among 190 patients seeking care at the emergency department (ED) for acute shortness of breath. Out of 115 patients with confirmed HF, 107 (94%) had dyspnoea as their main symptom. There were no significant differences between those patients with HF and those who were not diagnosed as heart failure (NHF) (n = 75) in the descriptors of breathlessness, although patients with HF scored significantly (P = 0.03) higher on a visual analogue scale (VAS). In addition, they had significantly (P = 0.03) higher breathing frequency than NHF patients and they were significantly (P < 0.001) more likely to be treated with >40 mg furosemide. CONCLUSION: Assessment of acute dyspnoea using a VAS is useful in distinguishing HF from NHF, and may be a more valid approach as compared with using descriptors of intensity of breathlessness in the acute setting.
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| 8. |
- Hellström Ängerud, Karin, et al.
(författare)
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Areas for quality improvements in heart failure care : quality of care from the patient's perspective
- 2017
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Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 31:4, s. 830-838
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Heart failure is a serious condition with high mortality and a high symptom burden. Most patients with heart failure will be taken care of in primary care but the knowledge of how the quality of care is perceived by patients with heart failure is limited.OBJECTIVE: The aim was to explore how patients with heart failure report quality of care, in an outpatient setting.METHODS: Seventy-one patients with a confirmed diagnosis of heart failure and who were cared for in an outpatient setting were included in this cross-sectional study. Quality of care was assessed with a short form of the Quality from the Patient's Perspective questionnaire. The items measured four dimensions, and each item consists of both perceived reality of the received care and its subjective importance.RESULTS: Inadequate quality was identified in three out of four dimensions and in items without dimension affiliation. In total, inadequate quality was identified in 19 out of 25 items. Patients reported the highest level of perceived reality in 'my family member was treated well' and the lowest perceived reality in 'effective treatment for loss of appetite'. Effective treatment for shortness of breath was of the highest subjective importance for the patients.CONCLUSION: Important areas for improvement in the quality of care for patients with heart failure in an outpatient setting were identified, such as symptom alleviation, information, participation and access to care.
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