Revistas
Revista:
HEART AND LUNG
ISSN:
0147-9563
Año:
2022
Vol.:
51
N°:
2022
Págs.:
32 - 39
Background: Chronic heart failure (CHF) is a syndrome that greatly impacts people's lives. Due to the poor prognosis of CHF, together with the frequent exacerbations of symptoms, death is a topic that is very present in the lives of patients with CHF. Objective: To explore thoughts about death experienced by patients with chronic heart failure in their daily lives. Methods: A hermeneutic phenomenological study was carried out. Conversational interviews were conducted with 20 outpatients with chronic heart failure. Analysis of the responses was based on the method proposed by van Manen. Results: From the analysis, four main themes emerged: (1) Feeling afraid of the possibility of dying; (2) Acceptance of the possibility of death; (3) Desiring death for relief from suffering; and (4) Striving to continue living to enjoy family. Conclusions: This study presents, as a novel finding, that people with CHF experience the possibility of near death on a daily basis. This experience, which they must encounter on their own, makes them afraid. In addition, some of them, in view of the discomfort they are living, wish to die, with some even considering committing suicide. (C) 2021 The Authors. Published by Elsevier Inc.
Revista:
JOURNAL OF FAMILY NURSING
ISSN:
1074-8407
Año:
2022
Vol.:
28
N°:
1
Págs.:
17 - 30
Currently, the dying process in Spain is moving to the home environment where responsibility for care falls largely on the family, thereby challenging and testing the stability of the family. Previous research has focused on the impact of illness on the primary caregiver; therefore, a knowledge gap exists. This study aimed to understand families' unitary experiences of providing home care to terminally ill family member. Using the "Model of Interpersonal Relationship Between the Nurse and the Person/Family Cared For," narrative research included family and individual interviews with nine families (9 groups/23 individuals). Thematic narrative analysis was used to interpret the interviews. The results highlight the impact of illness on family well-being as a whole. Family members often felt abandoned while caring for an ill family member and wished to be cared for themselves. However, their immediate community and the nurses caring for their ill family member neglected them. A paradigm shift is required by society and in home care at the end of life to better support the family.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2021
Vol.:
44
N°:
3
Págs.:
351 - 360
Background. Establishing the level of chronic cardiac inpatient empowerment is essential. By doing so, it is possible to identify groups with a lower level. It also provides a basis for designing effective strategies to improve their control over decision making and the actions that affect their health and wellness. The shortage of studies of this phenomenon for this particular population and context suggests that such patients are not receiving proper care. Methods. A prospective and descriptive study was carried out. A validated Spanish version of the Patient empowerment in long-term conditions scale was used. The survey has 47 items, grouped into three dimensions: Positive attitude and feeling of control, Knowledge in shared decision making, and Seeking information and sharing with other patients. It was distributed 24 hours before hospital discharge. Results. Twenty five questionnaires were collected (81%). The mean global empowerment score of the patients was 165.92 +/- 20.9. The dimension Positive attitude and sense of control showed the lowest score, with a mean of 3.4 +/- 0.5. An inverse weak relationship was found between the level of empowerment and age (rho =-0.240; p = 0.000) while a positive one was found with 10-year survival (rho = 0,316; p= 0.01). Conclusion. The level of empowerment of the patients in this study was medium-high. The strategies used to address the care of this population should focus on working on their attitude towards the disease and perceived control of the situation, and should be individualized according to age.
Revista:
ANALES DEL SISTEMA SANITARIO DE NAVARRA
ISSN:
1137-6627
Año:
2021
Vol.:
44
N°:
3
Págs.:
351 - 360
Fundamento. Conocer el nivel de empoderamiento de las personas con insuficiencia cardiaca crónica hospitalizadas es crucial para identificar a las personas con un nivel de empoderamiento más bajo y fundamentar el diseño de estrategias efectivas para mejorar su control sobre las decisiones y acciones que afectan a su salud y bienestar. La falta de estudio de este fenómeno en esta población y contexto, sugiere que estos pacientes no están siendo atendidos adecuadamente.
Material y métodos. Estudio descriptivo, prospectivo. Se utilizó el Cuestionario de empoderamiento del paciente con enfermedad crónica, traducido y validado al español, que consta de 47 ítems, agrupados en tres dimensiones: Actitud positiva y sentido del control, Toma de decisiones compartida e informada, y Búsqueda de información y compartir entre iguales. Fue distribuido para su cumplimentación en las 24 horas previas al alta hospitalaria.
Resultados. Se recogieron 25 cuestionarios (81%). La puntuación global media de empoderamiento fue de 165,92 ± 20,9. La dimensión Actitud positiva y sentido de control fue la peor puntuada, con una media de 3,4 ± 0,5. Se encontró una relación inversa y débil entre el nivel de empoderamiento y la edad (rho¿=¿-0,240; p¿=¿0,000) y una relación débil y positiva con la supervivencia a los 10 años (rho¿=¿0,316; p¿=¿0,01).
Conclusión. El nivel de empoderamiento de los pacientes de este estudio fue medio-alto. Las estrategias para abordar la atención de esta población deberían centrarse en trabajar su actitud respecto a la enfermedad y percepción de control de la situación e individualizarse conforme a la edad.
Revista:
CLINICAL NURSING RESEARCH
ISSN:
1054-7738
Año:
2021
Vol.:
30
N°:
2
Págs.:
171 - 182
The complicated situation experienced by chronic heart failure (CHF) patients affects their entire well-being but clinical
practice continues to fail to adequately respond to their demands. The aim of this study was to understand the meaning of
living with CHF from the patient¿s perspective. A hermeneutic phenomenological study was conducted according to Van
Manen's phenomenology of practice method. Individual conversational interviews were held with 20 outpatients with CHF.
Six main themes emerged from the analysis: (1) Living with CHF involves a profound change in the person; (2) The person
living with CHF has to accept their situation; (3) The person with CHF needs to feel that their life is normal and demonstrate
it to others; (4) The person with CHF needs to have hope; (5) Having CHF makes the person continuously aware of the
possibility of dying; (6) The person with CHF feels that it negatively influences their close environment.
Revista:
JOURNAL OF ADVANCED NURSING
ISSN:
0309-2402
Año:
2020
Vol.:
76
N°:
1
Págs.:
275 - 286
Aim To explore the perception of normality in life experienced by patients with chronic heart failure. Design A hermeneutic phenomenological study was conducted. Methods Individual conversational interviews were held with 20 outpatients with chronic heart failure between March 2014-July 2015. Van Manen's phenomenology of practice method was used for data analysis. Results From the analysis, four main themes emerged: (a) Accepting my new situation; (b) Experiencing satisfaction with life; (c) Continuing with my family, social and work roles; and (d) Hiding my illness from others. Conclusions The present study makes a novel contribution to understanding the importance of the perception of normality in the lives of patients with chronic heart failure. It was found that patients need to incorporate this health experience into their lives and reach a 'new normal', thus achieving well-being. Several factors were identified that can help promote this perception in their lives; therefore, nursing interventions should be designed to help develop scenarios encouraging this normalization process. Impact Although the implications of having a sense of normality or experiencing 'normalization' of the illness process in life have been studied in other chronic patient populations, no studies to date have examined how patients with chronic heart failure experience this phenomenon in their lives. For the first time, the results of this research prove that the perception of normality is a key aspect in the experience of living with chronic heart failure.
Revista:
TESELA
ISSN:
1887-2255
Es preciso desarrollar entornos de la práctica que permitan realizar un trabajo de enfermería acorde a sus objetivos y capacitación, y a las necesidades de salud de las personas/familias. Las organizaciones están desarrollando modelos de práctica profesional de enfermería (MPPE), para empoderar a sus enfermeras y mejorar la calidad de sus intervenciones. Se presenta el MPPE de la Clínica Universidad de Navarra. Su estructura y valores están basados en el Modelo de relación interpersonal entre la enfermera y la persona/familia cuidada, obtenido de la investigación. Además, se han identificado y definido las características del entorno de la práctica profesional enfermera. La implicación más importante de su definición y desarrollo tiene que ser la mejora de la práctica de enfermería y de la relación que las enfermeras establecen con la persona/familia. Este hecho está asociado con una satisfacción de las enfermeras y de las personas/familia y de los resultados obtenidos.
Revista:
CONTEMPORARY NURSE
ISSN:
1037-6178
Año:
2017
Vol.:
53
N°:
2
Págs.:
217 - 234
Although the concept of Transforming care' is promising for improving health care, there is no consensus in the field as to its definition. The aim of this concept analysis is to develop a deeper understanding of the term Transforming care' within the nursing discipline, in order to facilitate its comprehension, implementation, and evaluation. We performed a comprehensive literature review on electronic databases such as Medline (PubMed), Cinahl (Ebsco), Cochrane Library, PsycINFO (Ovid), Web of Science, Wiley-Blackwell, ScienceDirect, and SpringerLink and used Walker and Avant's approach to analyse the concept. From the 20 studies selected for this analysis, 3 main attributes of Transforming care' were identified: patient-centredness, evidence-based change, and transformational leadership driven. We suggest an operational definition to facilitate the implementation of the concept in practice. Furthermore, we propose that implementation is guided by the following key ideas: (1) fostering a culture of continuous improvement; (2) encouraging bottom-up initiatives; (3) promoting patient-centred care; and (4) using transformational leadership. Lastly, the evaluation of Transforming care' initiatives should assess care processes and professionals' and patients' outcomes.
Revista:
EUROPEAN JOURNAL OF CANCER CARE
ISSN:
0961-5423
Año:
2016
Vol.:
25
N°:
4
Págs.:
551 - 569
The aim of the study was to understand the experience of people living with advanced-stage cancer through literature. The search included The Cochrane Library, PubMed, PsycInfo, CINAHL and Cuiden. Thirteen studies were included. A qualitative meta-synthesis was conducted. One thread emerged from the thematic synthesis: the desire to live as normally as possible, despite being aware of the proximity of death. Three themes also emerged: "a process that is unique" with its four sub-themes; "support network" and "health context," each of them having two sub-themes. This study concludes that living with advanced-stage cancer is a unique and complex process which has both positive and negative aspects. The review provides a comprehensive view of the experience, which considers the importance of the support network and the health context in which the person lives. In this study, "normalcy" is the adjustment to the new reality and living as closely as possible to the way one lived before the disease, while developing a new relationship with being finite and death. A better understanding of the experience of living with advanced-stage cancer will help health professionals to identify the needs of the patients in order to plan individual, high-quality care.
Revista:
JOURNAL OF CLINICAL NURSING
ISSN:
0962-1067
Año:
2016
Vol.:
25
N°:
17-18
Págs.:
2413 - 2429
AIMS AND OBJECTIVES:
To determine, from a systematic literature review, the experience of living with heart failure and to propose some practice guidelines and research questions.
BACKGROUND:
Chronic heart failure has been one of the fastest growing illnesses in recent decades, with almost 23 million people affected worldwide. This complex syndrome has multiple causes and appears when underlying heart disease is advanced. Currently, heart failure has no cure and leads to a significant deterioration in patients' quality of life.
DESIGN:
Qualitative meta-synthesis.
METHODS:
A qualitative meta-synthesis was conducted to extract and analyse qualitative research from the Cochrane, PubMed, CINAHL, PsycINFO, Web of Science and Cuiden databases. Snowball sampling and a manual search were performed to identify other relevant studies.
RESULTS:
Twenty-five qualitative studies were selected. The findings indicate that there are three main themes that describe the phenomenon. The first theme refers to the experiences related to the beginning of the process. The second theme is connected with the effects on the person: physical, emotional, social and spiritual changes. The third theme is linked with how to live with heart failure despite the illness, including the adjustment and coping process and how external resources can help them to manage.
CONCLUSIONS:
Heart failure has a major impact on the entire person, but some areas have not been addressed. By creating new tools to underst [...]
Revista:
INTERNATIONAL JOURNAL OF PALLIATIVE NURSING
ISSN:
1357-6321
Año:
2012
Vol.:
18
N°:
12
Págs.:
597-605
ICS Objective: To describe Spanish nurses' preparedness to care for hospitalised terminally ill patients and how this translates into care delivery.
Methods: An exploratory, sequential mixed methods study with two stages. Stage I used unstructured observations of 22 hospital nurses over 235 hours to understand their daily reality, followed by semi-structured interviews with 21 nurses to elicit their perspectives. Stage 2 was a regional survey (65% response rate) concerned with hospital nurses' opinions of caring for terminally ill patients and their perceived competence.
Results: The nurses felt competent to provide physical but not emotional care for terminally ill patients. They reported that care could be improved, particularly through providing more emotional care. This coincided with an observed focus on physical care. The nurses reported a lack of support in caring for terminally ill patients and wanted more education on emotional issues and dealing with their own feelings.
Conclusion: There is a need for an integrative approach in Spain that combines an educational programme with a supportive environment, focusing on developing nurses' competence to deliver emotional care and deal with their own feelings. Promoting a supportive environment might enable nurses to change their behaviour when caring for terminally ill patients and deal with patients' emotional as well as physical needs.
Revista:
JOURNAL OF CLINICAL NURSING
ISSN:
0962-1067
Año:
2011
Vol.:
20
N°:
17-18
Págs.:
2479-2489
Keywords:
evaluation research;
intervention;
nursing research;
quasi experiment;
research capacity;
research culture
Aims and objectives.¿ To evaluate a contextually framed intervention to increase nursing research capacity among clinical nurses in a Spanish hospital.
Background.¿ In Spain, there has been a paucity of nursing research and a lack of nursing research culture. Currently, with the European Convergence of educational programmes and qualifications, there is a growing interest in promoting nursing research in this country.
Design.¿ A quasi-experimental design.
Methods.¿ Using a control (n = 81) and an intervention group (n = 89) of nurses, pre- and postintervention data were collected from both groups to evaluate the impact of the intervention at three times. The intervention, implemented over one year, consisted of the establishment of a mentors¿ network and an educational programme with research courses and journal clubs. Data collection methods included questionnaires, objective tests and scales.
Results.¿ The nursing research capacity of the hospital developed moderately after the intervention, with an increase in participants¿ research capability (knowledge, skills and attitudes) and a decrease in some of the inhibiting factors identified in the context.
Conclusions.¿ A new comprehensive and contextually framed intervention to develop nursing research capacity has been designed, implemented and evaluated in a hospital. It contributed to the development of the nursing research culture in the context.
Relevance to clinical practice.¿ An increase in nursing research activity could improve the quality of nursing care through the incorporation of research evidence in practice. This intervention could be used as a model in other hospitals, and it should be evaluated in other contexts.
Revista:
Journal of Clinical Nursing
ISSN:
0962-1067
Año:
2010
Vol.:
19
N°:
1-2
Págs.:
217 - 226
