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Health-care encounters create both discontinuity and continuity in daily life when living with chronic heart failure — A grounded theory study

View Article: PubMed Central

ABSTRACT

Living with chronic heart failure (CHF) often involves lifelong contact with health care, more or less frequently, depending on fluctuating health-generating disruptions in everyday life. To reduce the influence on continuity in life, health-care professionals should preferably focus on supporting patients in managing their daily lives, based on their perspective. The aim of this study was to describe how the interaction in health-care encounters contributes to either continuity or discontinuity in the daily life for persons with CHF. Interviews with 18 participants were carried out, using the grounded theory method, through data collection and analysis. Two core concepts were constructed from data which reveal a model that illuminates the characteristics of the encounters, the actions of health-care professionals and the normative discourse. Patient-centred agenda consists of the categories: “Experiencing a subordinate approach,” “Objectifying during the encounter” and “Expected to be compliant.” This describes how health-care professionals enhance discontinuity in daily life by using a paternalistic approach in the encounter. Person-centred agenda consists of the categories: “Experiencing an empowering approach,” “Person-centredness during the encounter” and “Expected to be capable.” It describes how participants perceive that health-care professionals enable them to deal with everyday life which enhances continuity. The findings highlight the importance of health-care professionals’ attitudes and communication in encounters with patients. Health care must be designed to support and promote patients’ own strategic thinking by strengthening their self-image to enhance continuity in everyday life. The experience of discontinuity is based on the prevailing health-care culture which focuses on disease and medical treatment and regards it as superior to the illness experience in an everyday life context. We therefore strongly suggest a paradigm shift in the health-care organisation and culture in order to support the patients in their efforts to live a meaningful, rich life, in spite of the chronic illness CHF.

No MeSH data available.


The connection between the health-care encounters experienced as enhancing discontinuity or continuity in daily life.
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Figure 0001: The connection between the health-care encounters experienced as enhancing discontinuity or continuity in daily life.

Mentions: The findings are based on the participants’ experiences of the care encounter with health-care professionals and the descriptions include meetings with various professional representatives and various forms of health care. The health-care encounters are described by the participants as good or bad in relation to their extended experiences of continuity and discontinuity in life. These experiences are not solely based on emotions. They also illustrate rational actions and health-care environments, which are characterised by unspoken norms and procedures in the relationship between the patient and health-care professionals. The results have been summarised in two core concepts, patient-centred agenda and person-centred agenda. A tentative model illuminates the characteristics of the care encounters, the actions of health-care professionals and the normative discourse, see Figure 1. The results are presented below, with depersonalised quotes from the interviews.


Health-care encounters create both discontinuity and continuity in daily life when living with chronic heart failure — A grounded theory study
The connection between the health-care encounters experienced as enhancing discontinuity or continuity in daily life.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4490805&req=5

Figure 0001: The connection between the health-care encounters experienced as enhancing discontinuity or continuity in daily life.
Mentions: The findings are based on the participants’ experiences of the care encounter with health-care professionals and the descriptions include meetings with various professional representatives and various forms of health care. The health-care encounters are described by the participants as good or bad in relation to their extended experiences of continuity and discontinuity in life. These experiences are not solely based on emotions. They also illustrate rational actions and health-care environments, which are characterised by unspoken norms and procedures in the relationship between the patient and health-care professionals. The results have been summarised in two core concepts, patient-centred agenda and person-centred agenda. A tentative model illuminates the characteristics of the care encounters, the actions of health-care professionals and the normative discourse, see Figure 1. The results are presented below, with depersonalised quotes from the interviews.

View Article: PubMed Central

ABSTRACT

Living with chronic heart failure (CHF) often involves lifelong contact with health care, more or less frequently, depending on fluctuating health-generating disruptions in everyday life. To reduce the influence on continuity in life, health-care professionals should preferably focus on supporting patients in managing their daily lives, based on their perspective. The aim of this study was to describe how the interaction in health-care encounters contributes to either continuity or discontinuity in the daily life for persons with CHF. Interviews with 18 participants were carried out, using the grounded theory method, through data collection and analysis. Two core concepts were constructed from data which reveal a model that illuminates the characteristics of the encounters, the actions of health-care professionals and the normative discourse. Patient-centred agenda consists of the categories: “Experiencing a subordinate approach,” “Objectifying during the encounter” and “Expected to be compliant.” This describes how health-care professionals enhance discontinuity in daily life by using a paternalistic approach in the encounter. Person-centred agenda consists of the categories: “Experiencing an empowering approach,” “Person-centredness during the encounter” and “Expected to be capable.” It describes how participants perceive that health-care professionals enable them to deal with everyday life which enhances continuity. The findings highlight the importance of health-care professionals’ attitudes and communication in encounters with patients. Health care must be designed to support and promote patients’ own strategic thinking by strengthening their self-image to enhance continuity in everyday life. The experience of discontinuity is based on the prevailing health-care culture which focuses on disease and medical treatment and regards it as superior to the illness experience in an everyday life context. We therefore strongly suggest a paradigm shift in the health-care organisation and culture in order to support the patients in their efforts to live a meaningful, rich life, in spite of the chronic illness CHF.

No MeSH data available.