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  • 1.
    Jacobsson, Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Pihl, Emma
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Mårtensson, Jan
    Halmstad University, School of Social and Health Sciences (HOS).
    Fridlund, Bengt
    Halmstad University, School of Social and Health Sciences (HOS).
    Emotions, the meaning of food and heart failure: a grounded theory study2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 46, no 5, p. 514-522Article in journal (Refereed)
    Abstract [en]

    Background:

    Many patients with heart failure have generalized wasting, referred to as cardiac cachexia. This leads to skeletal muscle wasting, impaired mobility, reduced functional capacity and poor prognosis. Patients with heart failure have symptoms that can affect their food intake, for example breathing difficulties, fatigue, nausea, loss of appetite, early feeling of fullness and ascites. These dietary problems and patients' nutritional status, can be significantly improved by means of simple nursing interventions.

    Aim:

    This paper reports a grounded theory study which developed a theoretical model of experiences of food and food intake among patients with heart failure.

    Methods:

    A descriptive and exploratory design, with a grounded theory analysis, was used. Data were collected in 2002 through interviews with 11 patients with heart failure. Findings. Two core categories emerged: emotions and the meaning of food. Psychosocial meaning could be associated with positive feelings of well-being, or negative feelings of sorrow. Physiological meaning could be associated with positive feelings of comfort or negative feelings of burden. Patients' experiences of food and eating changed during the development of the disease. Feelings of fatigue and lack of appetite gave rise to a feeling of deprivation because of missing both eating and the related social environment. This could lead to a loss of personal identity.

    Discussion:

    Although the findings of a qualitative study cannot be generalized, they raise important clinical nursing issues. With increasingly shorter hospital stays, these problems will need to be addressed by community healthcare staff and family carers. Therefore, all healthcare professionals need knowledge about heart disease and information techniques if they are to be able to give appropriate care to this group.

    Conclusion:

    Ignorance about food and eating can easily lead to malnourishment, with an increased risk of the patients falling into a vicious circle. Implications of the study for health care practice and research are identified.

  • 2.
    Jacobsson, Anna
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Pihl-Lindgren, Emma
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Group for Research on health promotion and disease prevention.
    Malnutrition in patients suffering from chronic heart failure; the nurse's care2001In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 3, no 4, p. 449-456Article in journal (Refereed)
    Abstract [en]

    Chronic heart failure is associated with a bad prognosis with considerably shortened survival and repeated hospitalisations. Patients suffering from heart failure also have symptoms that can affect their food intake, for example, tiredness when strained, breathing difficulties and gastrointestinal symptoms like nausea, loss of appetite and ascites. Pharmacological therapy can lead to a loss of appetite, which will make the intake of food inadequate to fill the required energy and nutritional needs. The nurse's interest in and knowledge of diet issues can improve these patients' nutritional status, The aim of this literature review was to describe the nurse's interventions regarding malnutrition in patients suffering from chronic heart failure. The literature search gave 13 articles, which were analysed, and sentences whose content was related to the aim were identified. Three areas of content appeared; drug treatment and consequences, gastrointestinal effects, and information and education. The results show that the nutritional status of these patients can be significantly improved by means of simple nursing interventions. Future research should focus on controlled experimental studies to evaluate differences in body weight, body mass index and quality of life between patients suffering from chronic heart failure, who are taking part in a fully enriched nutrition intervention, and patients suffering from chronic heart failure, who are eating their normal diet.

  • 3.
    Pihl, Emma
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Jacobsson, Anna
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Fridlund, Bengt
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Strömberg, Anna
    Linköping University.
    Mårtensson, Jan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Depression and health-related quality of life in elderly patients suffering from heart failure and their spouses: a comparative study2005In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 7, no 4, p. 583-589Article in journal (Refereed)
    Abstract [en]

    Background:

    Little is known about the factors that influence the health outcome of elderly patients suffering from heart failure or the health of their spouses. The aim of this comparative study was to determine if older patients suffering from heart failure and their spouses experience similar levels of health-related quality of life (HRQOL) and depression. The aim was also to identify those factors that contribute to HRQOL and depression in patient-spouse pairs.

    Methods:

    Data were collected from 47 couples, using the Short Form 36 (SF-36) and Zung Self-rating Depression Scale (SDS) questionnaires.

    Results:

    Patients suffering from heart failure and their spouses differed significantly in their experience of the physical, but not the mental, health-related quality of life, with patients experiencing significantly worse physical functioning. Physical symptoms of heart failure seemed to dominate the experience of the patient and was positively related to mental health and inversely related to the New York Heart Association classification (NYHA class) and patients' depression. Depressive symptoms as reflected in SDS showed no significant difference between patients and spouses. Patients' depression was positively related to high NYHA class, while spouse depression was positively related with higher age of the patient.

    Conclusion:

    Physical symptoms seem to dominate the experience of heart failure.

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