Dialogues between nurses, patients with heart failure and their partners during a dyadic psychoeducational intervention: a qualitative study

Maria Liljeroos, Susanna Ågren, Tiny Jaarsma, Anna Stromberg, Maria Liljeroos, Susanna Ågren, Tiny Jaarsma, Anna Stromberg

Abstract

Objectives: To describe nurses' documentation of the content in a psychoeducational intervention inspired by Stuifbergen's model addressing cognitive, supportive and behavioural needs of patient-partner dyads affected by heart failure.

Design: A descriptive qualitative design was used analysing nurses' documentation in a dialogue guide based on a health promotion model.

Settings: The dialogue guide was used during three nurse-led sessions at two heart failure clinics in Sweden with patients affected with heart failure and their partners during the years 2005-2008.

Participants: The dialogue guides from 71 patient-partner dyads were analysed using direct deductive content analyses. Patients' mean age was 69 years and 31% were female, partners' mean age was 67 years and 69% were female.

Results: The findings supported the conceptual health promotion model and identified barriers, recourses and self-efficacy described by the dyads within each category.

Conclusion: The dyads described that during the sessions, they had gained enhanced knowledge and greater confidence to handle their life situation and expressed that they needed psychoeducational support during the whole illness trajectory. The results may guide and help to improve content and quality when caring for patients affected with heart failure and their partners and also when designing new interventions.

Trial registration number: NCT02398799; Post-results.

Keywords: communication; content analysis; dyad; family; heart failure; nurses; nursing; patient education; self-care; support.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
The conceptual health promotion model by Stuifbergen et al.
Figure 2
Figure 2
Cognitive, supportive and behavioural goals for each visit.

References

    1. Ponikowski P, et al. . ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 2016.
    1. Riegel B, Moser DK, Anker SD, et al. . State of the science: promoting self-care in persons with heart failure: a scientific statement from the American Heart Association. Circulation 2009;120:1141–63. 10.1161/CIRCULATIONAHA.109.192628
    1. Buck HG, Harkness K, Wion R, et al. . Caregivers’ contributions to heart failure self-care: a systematic review. Eur J Cardiovasc Nurs 2015;14:79–89. 10.1177/1474515113518434
    1. Clark AM, Spaling M, Harkness K, et al. . Determinants of effective heart failure self-care: a systematic review of patients’ and caregivers’ perceptions. Heart 2014;100:716–21. 10.1136/heartjnl-2013-304852
    1. Molloy GJ, Johnston DW, Witham MD. Family caregiving and congestive heart failure. Review and analysis. Eur J Heart Fail 2005;7:592–603. 10.1016/j.ejheart.2004.07.008
    1. Dinesen B, Nøhr C, Andersen SK, et al. . Under surveillance, yet looked after: telehomecare as viewed by patients and their spouse/partners. Eur J Cardiovasc Nurs 2008;7:239–46. 10.1016/j.ejcnurse.2007.11.004
    1. Lamura G, Mnich E, Nolan M, et al. . Family carers’ experiences using support services in Europe: empirical evidence from the EUROFAMCARE study. Gerontologist 2008;48:752–71. 10.1093/geront/48.6.752
    1. Daugherty J, Saarmann L, Riegel B, et al. . Can we talk? Developing a social support nursing intervention for couples. Clin Nurse Spec 2002;16:211–8. 10.1097/00002800-200207000-00011
    1. Ohman M, Söderberg S. The experiences of close relatives living with a person with serious chronic illness. Qual Health Res 2004;14:396–410. 10.1177/1049732303261692
    1. Rees J, O’Boyle C, MacDonagh R. Quality of life: impact of chronic illness on the partner. J R Soc Med 2001;94:563–6.
    1. Agren S, Evangelista L, Strömberg A. Do partners of patients with chronic heart failure experience caregiver burden? Eur J Cardiovasc Nurs 2010;9:254–62. 10.1016/j.ejcnurse.2010.03.001
    1. Luttik ML, Jaarsma T, Veeger N, et al. . Caregiver burden in partners of Heart Failure patients; limited influence of disease severity. Eur J Heart Fail 2007;9(6-7):695–701. 10.1016/j.ejheart.2007.01.006
    1. Dunbar SB, Clark PC, Deaton C, et al. . Family education and support interventions in heart failure: a pilot study. Nurs Res 2005;54:158–66. 10.1097/00006199-200505000-00003
    1. Strömberg A. The crucial role of patient education in heart failure. Eur J Heart Fail 2005;7:363–9. 10.1016/j.ejheart.2005.01.002
    1. Srisuk N, Cameron J, Ski CF, et al. . Heart failure family-based education: a systematic review. Patient Educ Couns 2016;99:326–38. 10.1016/j.pec.2015.10.009
    1. Evangelista LS, Strömberg A, Dionne-Odom JN. An integrated review of interventions to improve psychological outcomes in caregivers of patients with heart failure. Curr Opin Support Palliat Care 2016;10:24–31. 10.1097/SPC.0000000000000182
    1. Dunbar SB, Clark PC, Reilly CM, et al. . A trial of family partnership and education interventions in heart failure. J Card Fail 2013;19:829–41. 10.1016/j.cardfail.2013.10.007
    1. Löfvenmark C, Saboonchi F, Edner M, et al. . Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial. J Clin Nurs 2013;22(1-2):115–26. 10.1111/j.1365-2702.2012.04201.x
    1. Etemadifar S, Bahrami M, Shahriari M, et al. . The effectiveness of a supportive educative group intervention on family caregiver burden of patients with heart failure. Iran J Nurs Midwifery Res 2014;19:217–23.
    1. Liljeroos M, Ågren S, Jaarsma T, et al. . Long term follow-up after a randomized integrated educational and psychosocial intervention in patient-partner dyads affected by heart failure. PLoS One 2015;10:e0138058 10.1371/journal.pone.0138058
    1. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 2000;55:68–78. 10.1037/0003-066X.55.1.68
    1. Stuifbergen A, Becker H, Rogers S, et al. . Promoting wellness for women with multiple sclerosis. J Neurosci Nurs 1999;31:73–9. 10.1097/01376517-199904000-00003
    1. Pender NJ, Pender AR. Health promotion in nursing practice. 2nd ed Norwalk, Conn: Appleton & Lange, 1987.
    1. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977;84:191–215. 10.1037/0033-295X.84.2.191
    1. Bandura A. Self-efficacy: The exercise of control. New York: W.H. Freeman, 1997.
    1. Stuifbergen AK, Becker H, Blozis S, et al. . A randomized clinical trial of a wellness intervention for women with multiple sclerosis. Arch Phys Med Rehabil 2003;84:467–76. 10.1053/apmr.2003.50028
    1. Revenson TA, et al. . Caregiving in the illness context. 2016.
    1. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191–4. 10.1001/jama.2013.281053
    1. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005;15:1277–88. 10.1177/1049732305276687
    1. Potter WJ, Levine-Donnerstein D. Rethinking validity and reliability in content analysis. Journal of Applied Communication Research 1999;27:258–84. 10.1080/00909889909365539
    1. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs 2008;62:107–15. 10.1111/j.1365-2648.2007.04569.x
    1. Patton MQ. Qualitative research & evaluation methods. London: SAGE, 2002.
    1. Lincoln Y, Guba E. Naturalistic inquiry. Newbury Park, London: Sage Publications Inc, 1985.
    1. Strömberg A. The situation of caregivers in heart failure and their role in improving patient outcomes. Curr Heart Fail Rep 2013;10:270–5. 10.1007/s11897-013-0146-8
    1. Duggleby W, Holtslander L, Kylma J, et al. . Metasynthesis of the hope experience of family caregivers of persons with chronic illness. Qual Health Res 2010;20:148–58. 10.1177/1049732309358329
    1. Gallagher R, Luttik ML, Jaarsma T. Social support and self-care in heart failure. J Cardiovasc Nurs 2011;26:439–45. 10.1097/JCN.0b013e31820984e1
    1. Pressler SJ, Gradus-Pizlo I, Chubinski SD, et al. . Family caregivers of patients with heart failure: a longitudinal study. J Cardiovasc Nurs 2013;28:417–28. 10.1097/JCN.0b013e3182563877
    1. Cocchieri A, Riegel B, D’Agostino F, et al. . Describing self-care in Italian adults with heart failure and identifying determinants of poor self-care. Eur J Cardiovasc Nurs 2015;14:126–36. 10.1177/1474515113518443
    1. Doherty LC, Fitzsimons D, McIlfatrick SJ. Carers’ needs in advanced heart failure: A systematic narrative review. Eur J Cardiovasc Nurs 2016;15:203–12. 10.1177/1474515115585237
    1. Nordlund A, Berggren J, Holmström A, et al. . Frequent mild cognitive deficits in several functional domains in elderly patients with heart failure without known cognitive disorders. J Card Fail 2015;21:702–7. 10.1016/j.cardfail.2015.04.006
    1. Cannon JA, McMurray JJ, Quinn TJ. ‘Hearts and minds’: association, causation and implication of cognitive impairment in heart failure. Alzheimers Res Ther 2015;7:22 10.1186/s13195-015-0106-5
    1. Liljeroos M, Agren S, Jaarsma T, et al. . Perceived caring needs in patient-partner dyads affected by heart failure: a qualitative study. J Clin Nurs 2014;23:2928–38. 10.1111/jocn.12588
    1. Riegel B, Dickson VV, Faulkner KM. The situation-specific theory of heart failure self-care: revised and updated. J Cardiovasc Nurs 2016;31:226-35 10.1097/JCN.0000000000000244
    1. Browne S, Macdonald S, May CR, et al. . Patient, carer and professional perspectives on barriers and facilitators to quality care in advanced heart failure. PLoS One 2014;9:e93288 10.1371/journal.pone.0093288
    1. Sebern MD, Woda A. Shared care dyadic intervention: outcome patterns for heart failure care partners. West J Nurs Res 2012;34:289–316. 10.1177/0193945911399088

Source: PubMed

3
구독하다