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Registered nurses' perceptions about the situation of family caregivers to patients with heart failure a focus group interview study
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-6448-5866
Univ Borås, Fac Caring Sci Work Life & Social Welf, Borås, Sweden..
Cty Council Västmanland, Västmanlands Hosp Västerås, Primary Hlth Care, Västerås, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-5976-5193
2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 8, E1-E18 p.Article in journal (Refereed) Published
Resource type
Text
Abstract [en]

INTRODUCTION: Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes.

AIMS: The aims of this study are to explore registered nurses' perceptions about the situation of family caregivers to patients with heart failure, and registered nurses' interventions, in order to improve family caregivers' situation.

METHODS: The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis.

RESULTS: Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area "Family caregivers' situation" includes two categories: "To be unburdened" and "To comprehend the heart failure condition and its consequences". The content area "Interventions to improve family caregivers' situation" includes two categories: "Individualized support and information" and "Bridging contact".

CONCLUSIONS: Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care" and or Family-centred care. Registered nurses consider it necessary to have a coordinated individual care plan as a basis for collaboration between the county council and the municipality.

Place, publisher, year, edition, pages
2016. Vol. 11, no 8, E1-E18 p.
National Category
Nursing
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-31683DOI: 10.1371/journal.pone.0160302ISI: 000374486500156Scopus ID: 2-s2.0-84983358884OAI: oai:DiVA.org:mdh-31683DiVA: diva2:932685
Available from: 2016-06-02 Created: 2016-06-02 Last updated: 2017-04-19Bibliographically approved
In thesis
1. Family caregiving for persons with heart failure: Perspectives of family caregivers, persons with heart failure and registered nurses
Open this publication in new window or tab >>Family caregiving for persons with heart failure: Perspectives of family caregivers, persons with heart failure and registered nurses
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Heart failure is a growing public health problem associated with significant morbidity and mortality. Family support positively affects outcomes for the person with heart failure while also leading to caregiver burden. Registered nurses have a key role in supporting and meeting the needs of family caregivers.

The overall aim was to explore the situation and needs of family caregivers to a person with heart failure, and explore requisites and ways of supporting and involving family caregivers in heart failure nursing care.

Two interview studies, one web survey study and one intervention study were conducted between 2012 and 2017. A total of 22 family caregivers, eight persons with heart failure and 331 registered nurses participated in the studies.

Family caregivers' daily life was characterized by worry, uncertainty and relational incongruence but salutogenic behaviours restored new strength and motivation to care. Family caregivers experienced that their caregiving was taken for granted by health care professionals. Family caregivers expressed a need for a permanent health care contact and more involvement in the planning and implementation of their near one’s health care together with health care professionals. Registered nurses acknowledged family caregivers’ burden, lack of knowledge and relational incongruence. A registered nurse was suggested as a permanent health care contact to improve continuity and security. Registered nurses neither acknowledged family caregivers as a resource nor their need for involvement. Registered nurses working in primary health care centres, in nurse-led heart failure clinics, with district nurse specialization, with education in cardiac nursing care held the most supportive attitudes toward family involvement in heart failure nursing care. Family health conversations via telephone in nurse-led heart failure clinics were found to successfully support and involve families. The conversations enhanced nurse-family relationship and relations within the family. They also provided registered nurses with new, relevant knowledge and understanding about the family as a whole. Family health conversations via telephone were feasible to both families and registered nurses, although fewer and shorter conversations were preferred by registered nurses.

This thesis highlights the divergence between family caregivers’ experiences and needs, and registered nurses’ perceptions about family caregivers’ situation and attitudes toward the importance of family involvement. It adds to the knowledge on the importance to acknowledge family caregivers as a resource and to support and involve them in heart failure nursing care. One feasible and successful way is to conduct Family health conversations via telephone in nurse-led heart failure clinics.

Place, publisher, year, edition, pages
Västerås: Mälardalen University, 2017
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 228
Keyword
Attitudes, cardiovascular nursing, caregiving, content analysis, family, family caregiver, family-centered nursing, family systems theory, heart failure, informal caregiver, interview, intervention, older person, pretest-posttest design, questionnaire, web survey, Anhörigvårdare, attityder, familj, familjecentrerad omvårdnad, frågeformulär, före- och efter design, hjärtsvikt, informell vårdgivare, innehållsanalys, intervention, intervju, kardiovaskulär omvårdnad, webbenkät, äldre person
National Category
Nursing
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-35194 (URN)978-91-7485-329-2 (ISBN)
Public defence
2017-06-15, Delta, Mälardalens högskola, Västerås, 13:15 (English)
Opponent
Supervisors
Available from: 2017-04-28 Created: 2017-04-19 Last updated: 2017-07-10Bibliographically approved

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