miun.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Recovery from an Acute Myocardial Infarction: A Longitudinal Study of Couples
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to investigate recovery in the relationshipbetween couples following an acute myocardial infarction [AMI]. An additionalaim was to compare differences over time regarding hope and health‐relatedquality of life [HRQoL] for both patient and partner. The thesis is based on fourempirical studies (I‐IV), and has a longitudinal design employing both qualitativeand quantitative methods. A purposive sample was recruited comprising 15couples in which one partner had been diagnosed with an AMI. Study I wascarried out as individual tape‐recorded interviews aimed at describing thepatient´s and their partner´s experiences after hospital discharge. Study II alsoused individual tape‐recorded interviews, this time with the aim of describing andinterpreting the couple´s thoughts and expectations about their future life after thepatients’ discharge. Study III used the HHI‐S and SF‐36 measures to comparechanges over time in self‐rated hope and health‐related quality of life, anddifferences between patients’ ratings and their partner´s. Study IV used repeatedindividual tape‐recorded interviews with the aim of interpreting the couples´narratives about their relationship and daily life. The data were analysed andinterpreted using a number of qualitative content analysis methods (I, II, IV) anddescriptive and comparative statistics (III).Overall, the couples´ recovery from an AMI in the two years after an AMI consisted of a striving to reach some kind of balance and stability in their currentlife situation. The period after discharge from the hospital involved understandingthe importance of the home as a place in which one feels at home and which bringsa feeling of safety, experiencing the phenomenon of security and being at homewithin oneself, and seeking normalisation in returning to an ordinary life (I). Thecouples´ thoughts about their future lives were either optimistic, taking an activeapproach, or pessimistic, taking a wait‐and‐see approach. The couples could bedivided into four positions in terms of their visions of the future: life companions,who were in concordance regarding their future; tightrope walkers, who had incommon a need to reprioritise what they considered important in their future;pathfinders, who had in common an undefined vision of their future and observers, who saw their future including both physical as well as sociallimitations (II). Self‐rated hope and HRQoL both improved over time, but few ofthese improvements were statistically significant, and I found no statistically groupeffects. Estimation of the MDC index revealed that neither HHI‐S nor SF‐36measures stable traits (III). Finally, the repeated interviews revealed how thecouples viewed their daily life, mutual relationships and roles in their relationshipVIIover time. There was an abundant variation in a number of the couples´ storiesabout their relationship and daily life during the recovery period (IV).In conclusion, it is clear that what happen to one party in a relationship influencesthe other party. The couples in the studies showed improvements in both hope andhealth‐related quality of life over time. The HHI‐S and SF‐36 measures seemed tobe sensitive to and affected by the current situation. Going through an AMI is alife‐changing event that makes it necessary for the couple to make adjustments andadapt to their new situation. Different couples have different approaches tohandling this situation; no two couples are the same, and every couple willperceive and deal with the AMI differently. An AMI starts a process of transition,and over time a couple affected by AMI will undergo external as well as internal changes.

Abstract [sv]

Avhandlingens övergripande syfte var att undersöka återhämtning i parrelation efter hjärtinfarkt. Ett ytterligare syfte var att jämföra skillnader avseende hopp och hälsorelaterad livskvalitet över tid men också emellan patienter och deras partners.Avhandlingen baseras på fyra delstudier (I‐IV), och har en longitudinal designmed både kvalitativa och kvantitativa metoder. Ett ändamålsenligt urval av 15 par rekryterades där en i parrelationen diagnostiserats med akut hjärtinfarkt. DelstudieI genomfördes med individuella bandinspelade intervjuer med syfte att beskrivapatienter och deras partners erfarenheter efter utskrivning från sjukhus eftergenomgången hjärtinfarkt. Delstudie II använde också individuella bandinspelade intervjuer, den här gången med syfte att beskriva och tolka parens tankar ochförväntningar kring deras framtid efter att patienten skrivits ut från sjukhus.Delstudie III använde instrumenten HHI‐S och SF‐36 för att jämföra skillnader av självskattat hopp och hälsorelaterad livskvalitet över tid och emellan patienter och deras partners. Delstudie IV använde upprepade bandinspelade intervjuer medsyfte att tolka parens berättelser kring deras relation och det dagliga livet. Data haranalyserats och tolkats med kvalitativ innehållsanalys på olika sätt (I,II,IV) ochmed såväl deskriptiv som jämförande statistik (III).Avhandlingen visar att parens återhämtning efter hjärtinfarkt under en period avtvå år omfattar en strävan efter att uppnå någon form av balans och stabilitet i denrådande livssituationen. Perioden efter utskrivning från sjukhus innebar enförståelse för hur viktigt hemmet är som plats för att känna sig hemma eller för att skapa en känsla av trygghet samt erfarenheter av fenomenet trygghet och attkänna sig hemma i sig själv. Slutligen sökte paren efter normalisering för att återkomma till det vanliga livet (I). Parens tankar kring deras framtid var antingenoptimistisk, en aktiv inställning, eller pessimistisk, en vänta ‐ och ‐ se inställning.Paren kunde också grupperas i fyra positioner som beskrev deras visioner omframtiden. De som kallades livskamrater syntes vara i samklang vad gällde återhämtning, balanskonstnärerna hade gemensamt ett behov av att omprioriter a vad som var viktigt för framtiden, de som var gemensamt för de som kallades stigfinnare var deras odefinierade/oklara bild av framtiden och slutligenobservatörerna såg sin framtid omfatta såväl fysiska som sociala begränsningar(II). Både självrapporterat hopp och hälsorelaterad livskvalitet förbättrades övertid, men få av dem var statistiskt signifikanta och inga statistiska gruppeffekterhittades. Beräkning av MDC index visade att varken HHI‐S eller SF‐36 mäterstabila dimensioner (III). Slutligen visade de upprepade intervjuerna hur paren sågpå dagligt liv, den inbördes relationen och roller i relationen över tid. Det fanns enIXrikedom av variationer i parens berättelser om deras relation och det dagliga livetunder återhämtningsprocessen (IV).Till sist framträder det klart att det som händer den ene i relationen fårkonsekvenser för den andre. Paren i studierna visade på att det skeddeförbättringar vad gäller både hopp och hälsorelaterad livskvalitet över tid. BådeHHI‐S och SF‐36 är instrument som synes vara känsliga för och påverkade av denrådande situationen. Att gå igenom en hjärtinfarkt är en livsavgörande händelsesom fodrar att paren ställer in sig på och gör anpassningar till en ny situation.Paren har dock olika sätt att handskas med den nya situationen och det finns intetvå par som är lika, och inte heller uppfattar och hanterar de hjärtinfarkten i vardagen och i relationen på samma sätt. En hjärtinfarkt startar en transitionsprocess och över tid genomgår paren såväl yttre som inre förändringar.

Place, publisher, year, edition, pages
Östersund: Mid Sweden Univ , 2010. , p. 82
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 95
Keywords [en]
acute myocardial infarction, adaptation, adjustment, balance, couples, family, normalisation, stability, system theory, transition
National Category
Nursing
Identifiers
URN: urn:nbn:se:miun:diva-12120ISBN: 978-91-86073-96-1 (print)OAI: oai:DiVA.org:miun-12120DiVA, id: diva2:356658
Public defence
2010-11-19, F 234, Campus Östersund, Östersund, 16:01 (Swedish)
Opponent
Supervisors
Available from: 2010-10-15 Created: 2010-10-13 Last updated: 2010-10-18Bibliographically approved
List of papers
1. Patients´and their partners´experiences of returning home after hospital discharge following acute myocardial infarction
Open this publication in new window or tab >>Patients´and their partners´experiences of returning home after hospital discharge following acute myocardial infarction
2009 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 4, p. 267-273Article in journal (Refereed) Published
Abstract [en]

Background: Returning home from hospital after an acute myocardial infarction [AMI] can be a period of vulnerability both for the patient and his/her partner. This study focuses on the time immediately after discharge.

Aims: The aim of this study was to describe the patient’s and his/her partner’s experiences after hospital discharge following AMI.

Methods: 15 couples took part in individual interviews, 4- 8 weeks after discharge. Data were analysed using qualitative content analysis.

Results: The results are presented by means of three themes, ´ at home in one’s own home`, ´ at home within oneself ` and ´having normality in sight`, comprising ten categories that describe the experiences of both the patient and his/her partner.

Conclusions: The patients as well as partners described the period after discharge from hospital comprising ambitions of feeling safety in their home, an inner sense of security and seeking normalisation.The results of this study could be useful for nurses when planning for patient discharge. During hospitalization nurses can prepare both the patient and their partner for what to expect when the patient returns home.

Place, publisher, year, edition, pages
Elsevier, 2009
Keywords
Life-threatening illness, Interviews, Nursing, Qualitative content analysis
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-8940 (URN)10.1016/j.ejcnurse.2009.03.003 (DOI)000271701100006 ()19410517 (PubMedID)2-s2.0-70349453876 (Scopus ID)
Projects
Recovery from an acute myocardial infarction- as a process in the relationship
Available from: 2009-05-15 Created: 2009-05-15 Last updated: 2017-12-13Bibliographically approved
2. Couples´ thoughts about and expectations of their future life after the patient´s hospital discharge following acute myocardial infarction
Open this publication in new window or tab >>Couples´ thoughts about and expectations of their future life after the patient´s hospital discharge following acute myocardial infarction
2010 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 23-24, p. 3485-3493Article in journal (Refereed) Published
Abstract [en]

Aim: To describe and interpret couples’ thoughts and expectations about their future life after the patient’s discharge following acute myocardial infarction [AMI].

Background: An AMI is a challenge for both the patient and his/her partner, as it can disrupt family functioning and dynamics. Earlier research has generally focused on either the patient or the partner and few studies have explored the experiences of the couple.   

Design: Qualitative descriptive and interpretative.

Methods: 15 couples took part in individual interviews, 4-8 weeks after discharge. Data were analysed in two phases using qualitative content analysis.

Results: The first phase of the analysis revealed two categories: ‘an active approach to the future’ and ‘a wait-and-see approach to the future’, both of which described the participants’ thoughts about the future. In the second phase, the couples’ stories were interpreted and grouped into four positions: ‘the life companions’, ‘the tightrope walkers’, ‘the pathfinders’ and ‘the observers’, which illustrated their visions of the future.

Conclusions: Our results reveal differences in the couples’ thoughts about and expectations of their future life, most of them managed the situation by having a positive attitude to life and their future. The couples discovered their resources and compensated for or balanced each other in the early recovery period.

Relevance to clinical practice: The results indicate the importance of giving both partners the opportunity to express their views of the situation, as this increases nurses’ understanding of the impact of the illness on their life and relationship. However, the results also highlight the significance of seeing the couple and showing them consideration both as individuals and as a unit.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2010
Keywords
acute myocardial infarction, couple, qualitative content analysis, future plans, recovery, nursing
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-11469 (URN)10.1111/j.1365-2702.2010.03292.x (DOI)000284369800025 ()21029224 (PubMedID)2-s2.0-78649601856 (Scopus ID)
Available from: 2010-04-30 Created: 2010-04-30 Last updated: 2017-12-12Bibliographically approved
3. Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study
Open this publication in new window or tab >>Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 295-302Article in journal (Refereed) Published
Abstract [en]

Background:  Acute myocardial infarction (AMI) is a life-changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period.

Aims:  To compare self-rated scores of hope and health-related quality of life (HRQoL) 1, 7, 13 and 25 months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners.

Design:  Explorative and longitudinal study.

Methods:  In this nonrandomized study, Short Form 36 Health Questionnaire (SF-36) and Herth Hope Index-Swedish (HHI-S) questionnaires were completed by thirteen post-AMI patients and their partners. Data were collected on four occasions.

Results:  In general, hope as well as HRQoL scores increased over time. A 2 (groups) × 4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC-index) for HHI-S and SF-36 revealed that scores between data collection points were not stable.

Conclusion:  Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI-S nor SF-36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation.

Relevance to clinical practice:  These results can be used in the training of nursing staff to enhance their understanding of the significance of a family-centred approach after an AMI.

Keywords
Acute myocardial infarction, Health Related Quality of Life, Hope, Minimum Detectable Change, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-12057 (URN)10.1111/j.1471-6712.2012.01032.x (DOI)000318815700012 ()2-s2.0-84877831127 (Scopus ID)
Available from: 2010-09-29 Created: 2010-09-29 Last updated: 2017-12-12Bibliographically approved
4. Couples´experiences of their relationship over a two year period following an acute myocardial infarction: A longitudinal qualitative study
Open this publication in new window or tab >>Couples´experiences of their relationship over a two year period following an acute myocardial infarction: A longitudinal qualitative study
(English)Manuscript (preprint) (Other academic)
Keywords
Life changing events, Longitudinal, Myocardial infarction, Recovery, Spouses, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:miun:diva-12056 (URN)
Available from: 2010-09-29 Created: 2010-09-29 Last updated: 2016-12-09Bibliographically approved

Open Access in DiVA

fulltext(843 kB)2390 downloads
File information
File name FULLTEXT02.pdfFile size 843 kBChecksum SHA-512
606bb96aedb670479bfada0cd6c36774e18e144dd2d7055ed931e607002ed8d21413d9b8146d476c3e31d05ea58f1dc74befe6a2535d2628868df956bf070c9c
Type fulltextMimetype application/pdf

Authority records BETA

Eriksson, Monica

Search in DiVA

By author/editor
Eriksson, Monica
By organisation
Department of Health Sciences
Nursing

Search outside of DiVA

GoogleGoogle Scholar
Total: 2390 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 2054 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf