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The aim of this research was to review four studies on nursing practice concerning patients with cardiovascular problems. The paper portrays the behavior of patients comprehensively by identifying, synthesizing, and decisively analyzing the research articles. An integrative review method is used for each article. The articles included four qualitative studies. The behavior patterns of patients with heart problems guided the development of points that included study methods, findings, discussions, and recommendations. Regardless of the method used, the studies illustrated the importance of physical, emotional, religious, and moral fitness in reducing heart problems. The improvement of patients’ health is determined mostly by individual behavior. With increased knowledge of the factors that leverage lifestyle, nursing practitioners can be able to help patients with heart problems better and more effectively.
Physical activity among south Asian Indian immigrants
Unlike many killer diseases such as arthritis, diabetes, and obesity, the risk of getting cardiovascular disease can be reduced through physical exercise. The observation is general to people from different races. However, the severity of the disease is varied among the races. Daniel and Wilbur embarked on a mission to investigate the variation with the aim of portraying correlates of lifestyle among the South Asian Indians (Daniel & Wilbur, 2011). The lifestyles emphasized included leisure-time, household, and occupation. The methodology employed by these researchers involved three major development activities. First, they designed and sampled the review data while employing Ganong’s stages as well as Whittemore and Knafls updated guidelines established in 1987 and 2005 respectively. The strength of this activity revolves around the extensive collection, analysis, and synthesis of data. Next, the researchers measured the collected information with the help of tools such as tables, recruitment, demographic characteristics, and dynamic characteristics. The analytic strategy was the final activity that included the checking of inconsistencies in the reviewed studies.
Results from Daniel and Wilbur’s review revealed that the studies on South Asian Indians were extensive, but vague. Most of them were characterized by weaknesses such as biasness, poor research methodologies, insufficient data, and dilute samples. Despite the associated weaknesses, the general finding was that South Asian Indians lacked adequate physical activities. Indeed, many did not consider the exercise as a method of reducing cardiovascular disease. Hence, the disease predominated more in the group as compared to other ethnic groups. There were variations in gender and men were found to be more active than women. The motivation to physical exercise was to improve on health and social status. Hence, the researchers were able to conclude that South Asian Indians could reduce the risk of getting cardiovascular disease if they engaged more in physical exercise. Discrimination is not the major barrier, but intrapersonal behaviors.
Understanding dietary decisions
Evidence shows that specific diets can reduce the incidence of coronary events hence lowering the risk of cardiac infections. Triggered by the EUROACTION study that showed a lack of cardiovascular disease prevention, Doyle, Fitzsimons, McKeown, and McAloon embarked on a mission to explore the issues that influence patients attending a secondary prevention clinic to make dietary decisions (Doyle, Fitzsimons, McKeown & McAloon, 2010). The researchers employed a qualitative methodology that used phenomenology reflected in Colaizzi’s work in an effort to facilitate detailed exploration of patients’ experiences as well as understanding the motive behind their dietary decisions.
The methodology used as well as the purposive sample selected were strong elements of the study hence weakness like narrowness could not discredit the findings. Referring to Colaizzi’s methodology, three themes that facilitated change were identified – fear, determination, and self-control. The participants feared to die, aimed to live longer, or wished to stay healthy always. The fear increased the patients’ determination to do anything that could reduce the risk of getting the disease including eating healthily. The determination cultivated self-control in the patients differently, yet many of them made positive decisions on what food to eat. Themes that impeded change included lack of willpower, poor recall of information, and need for additional support. Most of the participants struggled to maintain the motivation to continue eating healthily. They went through depressing moments to the level of not remembering important information on healthy eating habits. Therefore, they felt that they needed extra help from different stakeholder such as health practitioners, friends, and relatives.
In that respect, the researchers discuss the importance of understanding these themes as the base for developing interventions that are more effective (Doyle, Fitzsimons, McKeown & McAloon, 2010). Fear is categorically the strongest theme that requires quick attention in order to bring the significance of the rest. When patients are free of fear, they can be more objective and proactive in deciding on the diets to settle on. Therefore, nurses are recommended to take critical measures when addressing behavioral changes in patients with cardiovascular disease. They should focus on various factors and characteristics that add to diet decisions up to the individual level of these patients.
Patients’ key experiences after coronary artery bypass grafting
Coronary artery bypass graft surgery (CABG) is a process that incorporates your own veins to bypass narrowed areas in order to boost your blood flow into the heart. The complication has been a common phenomenon in patients over 40 years in Northern American and European hospitals. However, coronary artery bypass grafting has proven to be an effective therapy for ischemic coronary heart disease. Care after surgery is vital to patients with ischemic in order to control risk factors. These include instructions on how to help patients at home, strategies on how to reduce cholesterol levels, exercises, control of blood pressure and stopping smoking.
The objective of this study was to explore the patients’ experiences during post coronary artery bypass graft through qualitative studies, integrative synthesis, and literature review (Leegaard & Fagermoen, 2008). Notably, this research can be used to restore hope to these patients as they try to cope with the life-threatening disease and other challenges. The study was conducted using different methods such as; qualitative meta-synthesis, integrative approach, and literature review. Qualitative meta-synthesis is a unique approach where you integrate all qualitative analysis for individual studies with a specified qualitative research. Through the integrative approach, the research identified recurrent themes in literature and summarized the different study findings under thematic headings. Participants regardless of gender, age, religion, and education were interviewed. In addition, the time chosen was between their first experiences after discharge and a period of almost three years. Four databases were chosen – nursing, medicine, sociology, and psychology. In order to ensure scientific quality, peer review studies were incorporated in conjunction with the principles and terms of MeSH. The analysis also involved 16 varied bibliographic databases to boost the search strategy.
The analysis was performed to determine the findings that could be considered as abstract in relation to the problem statement. Descriptions on postoperative experiences were considered emotional or cognitive. Expectations were not considered findings. In addition, findings transcribed in abstract were identified as direct citations. The identification occurred after an analysis by experts to derive meaning in units that reflect experience in patients. Another stage was condensation and involved condensing the meaning units. Finally, themes were identified to illustrate the key experiences that were then presented in a table. The experience from patients showed that a supportive relation is vital in the recovery process. The patients cited how great it was to spend time with their loved ones for care and support. Surviving cardiac surgery was an experience by its own and a stepping-stone to a new life since CABG surgery is a near-death operation.
Almost all the participants were optimistic to adapt to a new phase in life. They consoled themselves with the condition and considered themselves lucky. That is why they were satisfied with their condition though it was characterized by sickness. Almost all participants responded well to treatment, as they were motivated to fight for survival. Successful operations and early discharge do not solely define postoperative experiences of patients. The phenomenon continues after surgery and has influence on the social life of the patient. Hope can be derived as dynamic way of coping with these patients. On the contrary, this search can be considered incomplete because it does not focus on the preoperative and surgery expectations.
Living with heart failure without realizing
Heart failure is a complex condition that occurs when the heart is unable to provide adequate power to pump blood. The condition has become a serious issue that needs attention in the Swedish healthcare as well as the United Kingdom (Andersson, Eriksson & Nordgren, 2012). It is vital to ensure that the involved parties are well informed and diagnosed in order to raise their standard of life and prognosis. At present, insufficient information on heart failure is available to the patients and their relatives. Patient information supports in coping with the condition and helps reduce stress. The objective of this paper was to investigate how patients with heart failure acquire and experience medical support in the primary health care. The research also reviewed the perceptions of these patients and came into a common policy and strategy that can boost patient care in future.
A qualitative research was conducted in order to derive and describe the experiences of patients living with heart failure. The location of search was a health care center in Sweden. To identify eligible participants, a medical record was used. Thirty-two participants were chosen, the mean age was 77, and all of them lived at home. Interviews were conducted and a qualitative analysis done in accordance with Graneheim and Lundman guidelines. The duration of interview was about 15 to 45 minutes. The study addressed the following questions; what do you consider to be a heart failure? What is health in general? Is your daily life affected by your symptoms? Apart from the heart symptoms, do you have any other symptoms? Is the disease limiting you from your daily activities? Is your social life affected by your physical health? How do you compare yourself with others? What would you like to be improved in the health care? What is your experience in health care?
After the interviews, the recordings were divided into meaning units. All protocols were observed such as confidentiality of patient information and the ethical aspects in relation to the ethical review board of Gothenburg. The study found that no support was given to the participants in the healthcare facility. The following categories described their experiences; lack of information, being abandoned, lack of dialogue, and non-developed strategies. Patients hardly got any support from the health care centers and the community in general. Moreover, they never accepted their symptoms to be those of heart failure and seemed to relate them to other heart-related complications.
The search portrayed how limited the participants were about their diagnosis knowledge. The authors insist on patient information as an important aspect for these individuals. Females thought that fatigue was the main cause of change of their social lives whereas the rest gradually adapted and adjusted to new day activities with change of their health. As a result of their aging, they never saw the significance of visiting a doctor as these conditions and symptoms appeared normal to them. The researchers recommends for community-based clinics where patients could seek consultation and diagnosis for heart failure. The research concluded that patients with heart failure lack information about their primary health care, which is a vital aspect in heart failure therapy. According to the research, there is need for more primary health-care for people with heart failure since very few know about their condition. Instead, they relate these symptoms to ageing.
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Andersson, L., Eriksson, I. & Nordgren, L. (2012). Living with heart failure without realizing: a qualitative patient study. British Journal of Community Nursing, 17(12), 630-637.
Daniel, M. & Wilbur, J. (2011). Physical activity among South Asian Indian Immigrants: An integrative review. Public Health Nursing, 28(5), 389-401.
Doyle, B., Fitzsimons, D., McKeown, P. & McAloon, T. (2010). Understanding dietary decision-making in patients attending a secondary prevention clinic following myocardial infarction. Journal of Clinical Nursing, 21 (2), 32-41.
Leegaard, M. & Fagermoen, S. M. (2008). Patients’ key experiences after coronary artery bypass grafting: a synthesis of qualitative study. Sc and J. Caring Sci, 22(11), 618-628.