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  • 1.
    Eriksson, Monica
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Recovery from an Acute Myocardial Infarction: A Longitudinal Study of Couples2010Doctoral 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.

  • 2.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hochwälder, Jacek
    Department of Public Health Sciences, Karolinska Institutet.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 295-302Article in journal (Refereed)
    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.

  • 3.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Couples´ thoughts about and expectations of their future life after the patient´s hospital discharge following acute myocardial infarction2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 23-24, p. 3485-3493Article in journal (Refereed)
    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.

  • 4.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Couples´experiences of their relationship over a two year period following an acute myocardial infarction: A longitudinal qualitative studyManuscript (preprint) (Other academic)
  • 5.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Patients´and their partners´experiences of returning home after hospital discharge following acute myocardial infarction2009In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 8, no 4, p. 267-273Article in journal (Refereed)
    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.

  • 6.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Elderly Spouses Experiences In Connection With Their Partners’ Death: A Literature Review2007In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 27, no 1, p. 43-46Article in journal (Refereed)
    Abstract [en]

    Previous generations’ inherent and natural knowledge of encouraging routines and rituals for mourning is no longer an obvious part of our society of today. The aim with this literature review was to present elderly spouses experience in connection with their partners’ death. The result has been achieved be qualitative content analysis of eleven scientific articles. The categories and sub- categories that appeared have been used to describe the altered life situation the elderly faced. Death involves a series of experiences for the surviving relatives and in order to cope with the situation there is a need to adapt to the different requirements. The spouses undergo varying stages of adjustment during the mourning. The conclusions from this literature review were that elderly surviving experiences altered over time but that loneliness remains during a very long space of time. Lack of social support and close connections compose risk factors, which have negative influences on the mental health. Over the years, the overall majority of the surviving adjusts well to the loss of their partner

  • 7.
    Eriksson, Monica
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Svedlund, Marianne
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The intruder': spouses' narratives about life with a chronically ill partner2006In: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 15, no 3, p. 324-333Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to illuminate the meaning of middle-aged spouse's experiences of living with a chronically ill partner. A purposive sample of four female spouses was selected for interviews using a narrative approach. BACKGROUND: When someone is diagnosed with a chronic illness, it is easy to understand that a considerable number of devastating consequences follow, both for the afflicted as well as for the family. Families often feel neglected and that their problems and needs are underestimated, if they do not personally draw attention to this fact. METHODS: A phenomenological hermeneutic method, inspired by the philosophy of Ricoeur, was used when interpreting the interview text. RESULTS: The experiences of spouses living with a chronically ill partner often brought a feeling of detachment from their partner's lives. The women experienced changes in their relationships because of their partners' disabilities; they had emotions of loneliness, despite living together as a couple. Through their actions, the women sought reassurance and support in order to maintain a meaningful partnership with their spouses and this is expressed in three themes: feelings of limitation, the struggle of everyday life and a striving for normalization. CONCLUSIONS: Middle-aged women living with a chronically sick partner are still of an active disposition and regard themselves as still being in mid-life. They wish to be loved as a wife and not as a care provider. RELEVANCE TO CLINICAL PRACTICE: The findings from this study can help increase the knowledge and understanding of the problems and concerns encountered by middle-aged spouses living with chronically ill partners and can be useful in the education and supervision of nurses and in relationship with relatives.

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