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När kroppen sätter gränser: En studie om att leva med hjärtsvikt i medelåldern
Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
2008 (Swedish)Doctoral thesis, comprehensive summary (Other academic)Alternative title
When the body sets limits : living with heart failure in middle age (English)
Abstract [en]

The overall aim of the present thesis was to describe the meaning of living with heart failure as a middle-aged person. In particular, the relation between the persons’ life-situations and formal care was explored. An additional aim was to uncover the meaning of support as experienced by people living with heart failure in middle age. The study used a caring science perspective and a reflective lifeworld approach, founded on phenomenological philosophy. Interviews were used for data collection and data were analyzed using essence-seeking analysis. The thesis is based on four empirical studies and the results were synthesized into a general structure, presented in the thesis.

The results of study I illuminate influences and changes to the life-situation that people living with heart failure in middle age can experience. The social world, i.e. intersubjective relationships, vocational situations, and formal care emerge as fundamental to the individuals, as well as the individuals’ own experiences of themselves and their body. The life-situation is frail and depicted by insecurity and uncertainty. The results of study II illuminate that people living with heart failure in middle age experience exposure and vulnerability in relation to formal care. While the context of formal care provides alleviation and medical treatments, the results at the same time revealed experiences of dependency and unclear participation. The results from studies III and IV clarify that support means to know that help is available concerning practical matters or flexibility at work. However, it also reveals that support means a sense of security or safety in relation to other people, such as friends, families, employees, and formal carers. Knowledge, and control are central aspects of the phenomenon of support in relation to heart failure.

The phenomenon’s general structure illustrate that living with heart failure as a middle-aged person is depicted by ambiguity in relation to other persons, daily life and formal care. The general structure is intertwined with an altered experience of the body, and a life-situation in a borderland between health and illness. The phenomenon is illuminated by the meaning constituents: A borderland between health and illness, and A tension between what is supportive and what is not. The phenomenon’s outer horizon is understood as A changed body and a threat against life, meaning that the phenomenon stands out against a background of the limits which the body sets on the persons.

The present study illustrates that support from others give people living with heart failure in middle age inner strength which they need if they are to adjust their life goals. However, the results also revealed that formal care at times is insufficient and the support which the patient’s need is forsaken. When people living with heart failure in middle age are to take on their own responsibilities for their health process they need information, knowledge and to be participating in care. Furthermore, formal carers need to focus more on the patient’s social roles and networks. A lifeworld-led perspective in formal care can unite a biomedical and a caring science perspective, and formal carers will be able to pay more attention to the patients’ changed life-situation rather than focusing the patient’s failing hearts.

Place, publisher, year, edition, pages
Växjö: Växjö University Press , 2008. , p. 176
Series
Acta Wexionensia, ISSN 1404-4307 ; 140/2008
Keywords [en]
heart failure, middle age, phenomenology, caring sciences
Keywords [sv]
hjärtsvikt, medelåldern, fenomenologi, vårdvetenskap
National Category
Nursing
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:vxu:diva-2001Libris ID: 10732815ISBN: 978-91-7636-593-9 (print)OAI: oai:DiVA.org:vxu-2001DiVA, id: diva2:205885
Public defence
2008-05-30, Myrdal, K, Georg Lückligs väg 4, Växjö, 10:30
Opponent
Supervisors
Available from: 2008-05-05 Created: 2008-05-05 Last updated: 2017-02-14Bibliographically approved
List of papers
1. Living with moderate-severe chronic heart failure as a middle-aged person.
Open this publication in new window or tab >>Living with moderate-severe chronic heart failure as a middle-aged person.
2007 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Qualitative Health Research, Vol. 17, no 1, p. 4-13Article in journal (Refereed) Published
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:vxu:diva-4816 (URN)10.1177/1049732306296387 (DOI)
Note

Part of urn:nbn:se:vxu:diva-2001

Available from: 2008-05-05 Created: 2008-05-05 Last updated: 2017-12-13Bibliographically approved
2. An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients.
Open this publication in new window or tab >>An exploration of the phenomenon of formal care from the perspective of middle-aged heart failure patients.
2007 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 6, no 2, p. 121-129Article in journal (Refereed) Published
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:vxu:diva-4817 (URN)
Note

Part of urn:nbn:se:vxu:diva-2001

Available from: 2008-05-05 Created: 2008-05-05 Last updated: 2017-12-13Bibliographically approved
3. Support as experienced by men living with heart failure in middle age: A phenomenological study
Open this publication in new window or tab >>Support as experienced by men living with heart failure in middle age: A phenomenological study
2008 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 9, p. 1344-1354Article in journal (Refereed) Published
Abstract [en]

Background

Men living with heart failure (HF) in middle-age experience restrictions limiting their work capacity and/or social activities. To adjust to the life-situation they need support. The meaning of the phenomenon of support is not well known. Thus, formal carers may find it problematic to know how to support patients.

Aim

The aim of the current study was to uncover and describe the meaning of the phenomenon of support as experienced by men living with HF in middle age.

Design

The study used a caring science perspective and a reflective lifeworld approach based on phenomenological philosophy.

Participants and settings

Nine men, aged 49–64 years and diagnosed with HF, were recruited from two outpatient HF clinics in Sweden.

Methods

Interviews were used for data gathering. Data were analyzed by means of reflective lifeworld research.

Findings

The essence of support as experienced by men living with HF in middle age can be understood as security, and a sense of having control over body and situation. Support is realized in the men's relations to other people; there is however tension between what is supportive and what is not, meaning that even though intentions are good, intended support involves limitations, uncertainties or insecurity. The essence is illuminated by the following meaning constitutes: Support—a tenuous security; Medications—a support for life; Conditional support within the context of formal care; and, Information and knowledge.

Conclusions

The meaning of support as experienced by men living with HF in middle age is multi-dimensional, qualitative and contextual. When the men are supported they gain a sense of security and control, giving them strength to handle their life-situation. A lifeworld-led approach in the context of formal care can help formal carers support men living with HF in middle age.

National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:vxu:diva-4818 (URN)10.1016/j.ijnurstu.2007.10.005 (DOI)
Note

Part of urn:nbn:se:vxu:diva-2001

Available from: 2008-05-05 Created: 2008-05-05 Last updated: 2017-12-13Bibliographically approved
4. Safety and understanding: Support as experienced by women living with heart failure in middle age
Open this publication in new window or tab >>Safety and understanding: Support as experienced by women living with heart failure in middle age
2008 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 1, p. 39-51Article in journal (Refereed) Published
Abstract [en]

To reformulate and adjust to their life-situation, women living with heart failure (HF) need help and support. However, the actual meaning of the phenomenon of support is not yet well described. The aim of the study was to uncover the meaning of the phenomenon of support as experienced by women living with HF in middle age. A reflective lifeworld approach within the perspective of caring science was used. Six women (aged 33–61 years) were interviewed. The findings show that the essence of support can be understood as safety, depicted by understanding. However, there is tension between what is supportive and what is not, meaning that even though intentions are good, intended support may involve limitations, uncertainties or insecurity. The meaning of support is further illuminated in the following constituents: “knowledge and understanding”, “finding balance”, “ambiguity of relationships” and “support and formal care—a matter of trust and mistrust”. Findings demonstrate the need for carers to find an approach that ensures both good quality medical care and, at the same time, acknowledges the uniqueness of each individual.

National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:vxu:diva-4819 (URN)10.1080/17482620701714780 (DOI)
Note

Part of urn:nbn:se:vxu:diva-2001

Available from: 2008-05-05 Created: 2008-05-05 Last updated: 2017-12-13Bibliographically approved

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Doctoral Thesis (Full text)(1728 kB)3581 downloads
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