Costello Jo-Anne, Boblin Sheryl
Cardiology Program, St Mary's Hospital, Kitchener Waterloo.
Can J Cardiovasc Nurs. 2004;14(3):9-20.
Congestive heart failure (CHF) is increasing in incidence and prevalence in both men and women in Canada. Research findings to date have been inconsistent with respect to whether gender differences influence quality of life, treatment and survival. There is a paucity of qualitative research describing the experience of patients with CHF This qualitative case study approach used semistructured interviews with women and men with New York Heart Association (NYHA) class three or four CHF who were referred to a CHF clinic. In addition to quality of life measures, data related to medical history, medical management and NYHA scores were collected to offer a thorough description of these clients' experiences. Three hypotheses were generated from 13 themes that emerged. First, the psychosocial impact of CHF outweighs the physical impact. Second, sex differences exist in relation to living with CHF with men being more accepting of CHF and more likely to experience social isolation and loss than women, while women are more likely to describe fear. Third, the experience of CHF is influenced by age with physical experiences and depression mentioned more frequently in younger age groups. Findings from this study have generated nursing implications and recommendations for further research.
在加拿大,充血性心力衰竭(CHF)在男性和女性中的发病率及患病率都在上升。就性别差异是否会影响生活质量、治疗及生存率而言,迄今的研究结果并不一致。描述CHF患者经历的定性研究很少。本定性案例研究采用半结构式访谈,对象是被转介到CHF诊所的纽约心脏协会(NYHA)心功能分级为三级或四级的CHF男性和女性患者。除了生活质量测量指标外,还收集了与病史、医疗管理及NYHA评分相关的数据,以便全面描述这些患者的经历。从出现的13个主题中得出了三个假设。第一,CHF的心理社会影响超过身体影响。第二,在CHF患者的生活方面存在性别差异,男性比女性更能接受CHF,且更有可能经历社会隔离和丧失,而女性更有可能描述恐惧。第三,CHF的经历受年龄影响,在较年轻年龄组中,身体体验和抑郁被提及得更频繁。本研究结果产生了护理方面的启示及进一步研究的建议。