The purpose of this paper is to describe how a selected group of United States patients with an implantable cardioverter-defibrillator perceived their life situation. A qualitative design based on the phenomenographic approach was chosen to describe the patients' conceptions of their life situation. Fourteen patients-eight men and six women, aged 21-84-were strategically selected to obtain as broad a variation as possible. The descriptive categories to emerge from the analysis of the interviews were trust, adaptability, and empowerment. The category labeled trust describes how patients trusted in the organization around them. The category labeled adaptability describes how patients adapted to living with an implantable cardioverter-defibrillator device. The category entitled empowerment describes how patients considered that they received support from family and friends as well as from health care professionals. This study suggests the need for a holistic intervention program comprising family, work, and leisure, focusing on patients' future life situation.

Objective: to gain a deeper understanding of how women who seek care at an early stage experience the latent phase of labour.

Design: a qualitative interview study using the grounded theory approach.

Setting: the study was conducted at a hospital in the southwestern part of Sweden with a range of 1600-1700 deliveries per year. The interviews took place in the women's homes two to six weeks after birth.

Participant: eighteen Swedish women, aged 22-36, who were admitted to the tabour ward while they were stilt in the latent phase of tabour.

Findings: 'Handing over responsibility' to professional caregivers emerged as the core category or the central theme in the data. The core category and five additional categories formed a conceptual model explaining what it meant to women being admitted in the early stage of tabour and their experiences of the Latent phase of tabour. The categories, which all related to the core category, were labelled: (1) 'longing to complete the pregnancy,' (2) 'having difficulty managing the uncertainty,' (3) 'having difficulty enduring the stow progress,' (4) 'suffering from pain to no avail' and (5) 'oscillating between powerfulness and powerlessness.'

Conclusions and implications for practice: findings indicate that women being admitted to the tabour ward in the latent phase of tabour experienced a need for handing over responsibility for the tabour, the welt-being of the unborn baby, and for themselves. Midwives have an important role in assisting women with coping during the latent phase of tabour, and in giving the women opportunity to hand over responsibility. This care should include validation of experienced pain and confirmation of the normality of the slow process, information and support. © 2007 Elsevier Ltd. All rights reserved.

OBJECTIVE: The study objective was to explore the main concern of individuals living with an implantable cardioverter defibrillator (ICD) and how they handle this in daily life. For improved management and follow-up, it is important to understand how the ICD affects the recipient's daily life. METHODS: A grounded theory method was used. Sixteen Swedish recipients (9 men) living with an ICD for 6 to 24 months were interviewed. RESULTS: The core category labeled, "Incorporating uncertainty in daily life," illuminates the main concern. To handle uncertainty, recipients used the following strategies: restricting activities, distracting oneself, accepting being an ICD recipient, and reevaluating life. CONCLUSION: Recipients were not paralyzed by uncertainty. Instead, they incorporated uncertainty in life by using strategies to handle their daily life. Questions, comments, and plans for supportive communication were provided, which can be used by healthcare professionals in cardiac rehabilitation.

Sjuksköterskan har en unik och central ställning för att genomföra hälsofrämjande arbete. Forskning visar dock att sjuksköterskor i klinisk verksamhet inte alltid är medvetna om att det övergripande målet med omvårdnaden är att stärka patientens hälsa. Fokus i omvårdnaden ligger i stället till stor del på att medverka i behandling av sjukdom. Förståelsen för hur patienten uppfattar sin situation och förmedlar sina behov för att stärka sin hälsa får ofta en mindre framträdande roll. För att omvårdnaden ska bli mer hälsofrämjande behövs ökad kunskap om vad hälsa och hälsofrämjande insatser innebär för den enskilde individen men också för olika grupper i befolkningen. Forskning om hälsofrämjande omvårdnad fokuserar ofta på att förebygga sjukdom. Därför behövs forskning som syftar till att öka hälsofokus i omvårdnaden, både vad det gäller utveckling av grundläggande perspektiv liksom kliniska strategier och modeller för hälsofrämjande omvårdnad på alla nivåer – på såväl individ-, grupp- som samhällsnivån.

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.

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.

BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.

Background: Increasing evidence about the high social and economic costs of poor mental health has contributed to a growing recognition of the need for health promotion interventions in mental health services. In spite of this, little empirical research has been performed investigating patients' attitudes to health promotion interventions. Aims: The aim of the present study was to investigate differences in patients' attitudes to health promotion interventions with regard to socio-demographic, clinical and health-related variables. Methods: The study has a cross-sectional design. The participants were recruited randomly and consisted of 141 outpatients, 91 women and 50 men. The participants rated their attitudes in accordance to the Health Promotion Intervention Questionnaire (HPIQ).   Results: The result showed a clear indication that there are gender differences in attitudes of health promotion interventions in mental health services. The main significant differences were that, females rated overall health promotion interventions as well as alliance and empowerment as more important than males did. Conclusions: It is suggested that gender issues have to be considered in health promotion interventions in mental health services and taken into account in the assessment, planning and delivery of the interventions as well as the evaluation of outcomes.

There is a growing recognition of the need for health promotion interventions in all health care today. In spite of this, health promotion interventions among patients with mental illnesses have been scarce in research, practice, and policies. There is also an ambiguous interpretation of the definition of health promotion in the literature. The emphasis in this paper is thus to (1) discuss why we should pay attention to the interpretations of the concept of health promotion and (2) present a possible model for what nurses do when they intend to promote health in mental health care. This paper was presented at the Nordic Conference of Mental Health Nursing in Helsinki, Finland in 2010.

The present study investigates attitudes towards aspects of health promotion in mental health services, as rated by patients and staff. The aim of the study was to investigate similarities and differences in attitudes towards health promotion interventions among patients and staff in mental health services, using a newly developed questionnaire, the Health Promotion Intervention Questionnaire (HPIQ). The study has a cross-sectional design and a sample of 141 patients and 140 staff were recruited to the study. The response rate was 59% for the patients and 50% for the staff. The participants were asked to rate the attitudes of the 19 items included in the HPIQ. The result showed that patients and staff in some cases share similar attitudes regarding aspects of health promotion intervention. According to both groups, empowerment is the most important intervention in health promotion. Significant differences between the ratings of patients and staff appeared regarding all subscales of HPIQ. Patients rated alliance and educational support significantly higher than staff and staff-rated empowerment and practical support significantly higher than patients. Based on these findings, it is of importance to meet patients' desire for information and knowledge in an interactive manner with an empowerment approach to promote health in mental health services.