From hope and expectation to unexpected death after cardiac surgery.
ABSTRACT Relatives of patients undergoing cardiac surgery expect successful outcome but sometimes complications cause death. The aim was to interview relatives of patients who have died in connection with cardiac surgery and describe their experiences of information, reception and care.
Data were obtained from semi-structured interviews with 18 relatives of deceased patients and then analysed using qualitative content analysis.
Two main groups emerged: "Analysing the situation" with the sub-groups: knowledge of cardiac disease, the road to operation, hope and despair, information and choice and "The thin thread of life" with the sub-groups, reception, life is over, care, death as a relief, cause of death and support.
Most relatives were satisfied with the information and care in connection with the operation and at the end of life. However, some aspects such as inadequate pain control and transportation of critically ill patients to other wards and hospitals could be improved. One way is to introduce a co-ordinator in order to better support patients, next of kin and colleagues without experience of cardio-thoracic surgery who need help during the patients' way from diagnosis and acceptance of cardiac surgery and through the treatment and postoperative care.
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ABSTRACT: It is important that patients for whom cardiac surgery is planned are supplied with structured oral and written information regarding their disease and its treatment, so that they can understand and discuss the coming operation and the risk of complications. The aim was to describe patients' experiences of information regarding possible complications related to cardiac surgery, both before and after the operation. A comparison was made between patients who received detailed written information (intervention group) regarding possible complications and patients who received conventional information (control group). One hundred eighty-two patients were included in the intervention group and 156 in the control group. Questionnaires were distributed and experiences, anxiety and depression (the Hospital Anxiety and Depression Scale, HADS), and avoidance or intrusion distress (the Impact of Event Scale, IES) were measured before and 8 weeks after the surgery. Seventy-two percent of the intervention group and 69% of the control group wanted information about both common and rare complications. Patients in the intervention group were significantly more satisfied with all aspects of the information compared to the control group both pre- and post-operatively. There were no significant differences between the groups for either the HADS or the IES. Most, but not all, patients in the present study were positive to the extended written detailed information about risk of complications in connection with cardiac surgery. Detailed information can be a useful base for fruitful conversations between the health care personnel and the patients. The patients and their next of kin are informed, and better prepared if complications occur.European Journal of Cardio-Thoracic Surgery 10/2005; 28(3):407-14. · 2.67 Impact Factor
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ABSTRACT: As qualitative research methods become more refined, so there is an increasing need to teach data analysis methods. This paper offers a group method--based on experiential learning principles--for teaching the analysis of textual data. Terms are defined, an outline for a preliminary theory input is offered and then the group method, itself, is described. Variants of the method are also described and various objections to the method are addressed.Nurse Education Today 09/1996; 16(4):278-81. · 1.22 Impact Factor
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ABSTRACT: The purpose of this study was to describe family care routines and to explore environmental factors when patients die in Swedish intensive care units (ICUs). The main research questions were: what are the physical environmental circumstances and facilities when caring for patients in end-of-life and are there any routines or guidelines when caring for dying patients and their families? A questionnaire was sent to 79 eligible Swedish ICUs in December 2003, addressed to the unit managers. The response rate was 94% (n = 74 units). The findings show that, despite recommendations highlighting the importance of privacy for dying ICU patients and their families, only 11% of the respondents stated that patients never died in shared rooms in their ICU. If a patient dies in a shared room, nurses strive to ensure a dignified goodbye by moving the body to an empty room or to one specially designated for this purpose. The majority (76%) of the units had waiting rooms within the ICU. The study also revealed that there is a need for improvements in the follow-up routines for bereaved families. Many units reported (51%) that they often or almost always offer a follow-up visit, although in most cases the bereaved family had to initiate the follow-up by contacting the ICU. Guidelines in the area of end-of-life care were used by 25% of the ICUs. Further research is necessary to acquire a deeper knowledge of the circumstances under which patients die in ICUs and what impact the ICU environment has on bereaved families.Scandinavian Journal of Caring Sciences 03/2007; 21(1):25-31. · 0.89 Impact Factor