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Patients' experiences of physical limitations in daily life activities when suffering from chronic heart failure: A phenomenographic analysis
Halmstad University, School of Social and Health Sciences (HOS), Centre of Research on Welfare, Health and Sport (CVHI).
School of Health Sciences, Jönköping University.
School of Health Sciences, Jönköping University.
2011 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 1, 3-11 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one's own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one's social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.

Place, publisher, year, edition, pages
Oxford: Wiley-Blackwell, 2011. Vol. 25, no 1, 3-11 p.
Keyword [en]
activities of daily life, chronic heart failure, elderly, nursing care, phenomenography, physical limitations
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-16231DOI: 10.1111/j.1471-6712.2010.00780.xISI: 000288571500002PubMedID: 20630034Scopus ID: 2-s2.0-79951529030OAI: oai:DiVA.org:hh-16231DiVA: diva2:441047
Note

Ingår i avhandling: Pihl, Emma. The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure. 2010.

Available from: 2011-09-14 Created: 2011-09-14 Last updated: 2012-12-14Bibliographically approved
In thesis
1. The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure
Open this publication in new window or tab >>The Couples' Experiences of Patients' Physical Limitation in Daily Life Activities and Effects of Physical Exercise in Primary Care when having Chronic Heart Failure
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore and describe couples’ experiences of patients’ physical limitation in activities of daily life and evaluate the effects of an exercise programme in primary care when having chronic heart failure (CHF). In Study I, a comparison between patients with CHF and their spouses was made regarding health-related quality of life and depression. Inthe thesis a comparison was also made between patients, spouses and specific age and gender matched norms. There were statistically significant differences in health-related quality of life between patients and spouses as well as between patients and their norms as in SF-36 scores. The deteriorated health-related quality of life in patients was most present in the physical component but also in social function in the mental component. There were no differences between patients and spouses in depression symptoms. In Study II, patients with CHF described their conceptions of physical limitation in daily life activities. A phenomenographic approach made it possible to identify variations of the conceptions and the referential aspects that emerged were: need of finding practical solutions in daily life, having realistic expectations about the future, not believing in one’s own ability and losing one’s social role in daily life. In Study III, spouses’ conceptions about the physical limitation in daily life activities in a loved one with CHF andthe impact these limitations had on their daily life were examined. The phenomenographic approach resulted in different referential aspects. These were: losing self-containment, missing communality, accommodating to the situation and finding satisfaction in life. Study IV aimed at determining effects of an exercise programme in primary care in elderly patients with CHF. The intervention period was 12 months with continuous exercise in the primary care centre and in the patients’ homes. Tests of physical capacity showed significant consistent improvement in the exercise group in arms and shoulders during the intervention and in the 6 minute walk test at 3 months compared to the control group. The physical dimension of Minnesota living with heart failure was significantly improved at 3 months and Euroqol5DVAS was significantly improved at 3 and 12 months in the exercise group compared to the control group. The thesis shows that patients and spouses conceive a variety of issues of physical limitation in daily life and the physical component of health-related quality of life is the most affected. The physical capacity in patients is possible to affect with an exercise programme in primary care and patient homes. The exercise programme is beneficial interms of physical capacity in the upper body and walked distance in 6 minutes.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2010. 122 p.
Series
Dissertation Series. School of Health Sciences, ISSN 1654-3602 ; 12
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-16235 (URN)978-91-85835-11-9 (ISBN)
Public defence
2010-10-22, R4312, Halmstad Högskola, Halmstad, 11:51 (Swedish)
Opponent
Supervisors
Available from: 2011-09-14 Created: 2011-09-14 Last updated: 2012-12-14Bibliographically approved

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Citation style
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