Family Nursing Therapeutic Conversations: Family Reorganization Processes After Diagnosis

• DOI: http://doi.org/10.1111/fare.12329
• Author: Barbara Voltelen,Birte Østergaard,Hanne Konradsen
• Date: 01 December 2018
• Published date: 01 December 2018

B V University of Southern Denmark & University College Lillebaelt

H K Karolinska Institutet

B Ø University of Southern Denmark

Family Nursing Therapeutic Conversations: Family

Reorganization Processes After Diagnosis

Objective: To explore and explain the readjust-

ment processes of families living with a fam-

ily member suffering from heart failure 1year

after having attended a heart failure clinic where

family nursing therapeutic conversations were

conducted.

Background: Living with heart failure is chal-

lenging for both the patient and the family

due to role shifts and drastic lifestyle changes.

Long-term support for the entire family is needed

from health care professionals. Evidence for

suitable family interventions is scarce.

Method: Joint interviews with 15 families in

which a member suffered from heart failure

were conducted. Theoretical sampling guided

the inclusion of families, and a grounded theory

approach was used to analyze data.

Results: The core category to emerge was reor-

ganizing family life, which included the process

of balancing competing needs on an individ-

ual level and as a family. The needs in ques-

tion involved maintaining personal integrity and

maintaining family bonds in the context of health

care and daily living.

Conclusions: The process of reorganizing fam-

ily life seemed to stabilize during the rst year.

Vestre Engvej 51C, 7100, University College Lillebaelt,

Vejle,Denmark (bavo@ucl.dk).

Key Words: family relations, family system nursing,

grounded theory,heart failure, illness, quality of life.

Exploring family illness narratives and fam-

ily perception of needs and goals guided by

health care professionals seem to support fam-

ilies’ well-being and adjustment processes.

Implications: Knowledge from this study could

improve collaboration between families and

health care professionals and support the com-

munication within families living with heart

failure.

Around 38 million people in the world experi-

enced heart failure in 2015 (Braunwald, 2015).

The condition has a serious impact on the

patient’s ability to perform normal daily activ-

ities and includes symptoms such as fatigue,

breathlessness, nausea, chest pain, and vertigo.

Daily living in the context of heart failure is

challenging for both patients and their families

because each family must adapt to the new

situation and treatment regimen. Diminished

patient function often induces role shifts and

drastic lifestyle changes (Dalteg, Benzein,

Fridlund, & Malm, 2011; Hilscher, Bartley,

& Zarski, 2005; Kang, Li, & Nolan, 2011;

Peng, 2014), sometimes leading to distress,

isolation, and depression (Luttik, Blaauwbroek,

Dijker, & Jaarsma, 2007). Research indicates

that the health status of people living with

cardiovascular disease who are also married or

living in marriage-like relationships is partially

dependent on the quality of that relationship, in

that a well-functioning marriage is associated

600 Family Relations 67 (December 2018): 600–614

DOI:10.1111/fare.12329