Pihl Emma, Fridlund Bengt, Mårtensson Jan
School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
Scand J Caring Sci. 2011 Mar;25(1):3-11. doi: 10.1111/j.1471-6712.2010.00780.x.
The aim of the study was to describe how patients suffering from chronic heart failure conceived their physical limitations in daily life activities. An explorative and qualitative design with a phenomenographic approach was chosen, a total of 15 patients were interviewed. The findings indicate that participants perceived a variety of structural aspects pertaining to physical limitations in activities of daily life which resulted in four referential aspects. Need of finding practical solutions in daily life focused on how life had to be changed and other ways of performing activities of daily life had to be invented. Having realistic expectations about the future was characterised by belief that the future itself would be marked by change in physical functioning, but an incentive to maintain functions and activities ensured good quality of or even increased capacity in daily life. Not believing in one's own ability included the perception of having no opportunity to improve ability to perform activities of daily life. There were perceptions of undesired passivity, undefined fear of straining themselves or performing activities that could endanger their health in addition to uncertainty about the future. In Losing one's social role in daily life, participants described losing their social network and their position in society and family because of limited physical capacity. A lack of important issues, mental and physical, occurred when physical capacity was lost. In conclusion, patients suffering from chronic heart failure found new solutions to manage activities in daily life, including willingness to change focus and identify other ways of doing important things. Patients had an incentive to maintain functions and activities to ensure a good quality of and strengthen their physical capacity in daily life. Inability to trust in their physical capacity in combination with experienced limitations in daily life prevented patients from attempting to increase activities.
该研究的目的是描述慢性心力衰竭患者如何看待他们在日常生活活动中的身体限制。本研究采用现象学方法进行探索性定性设计,共访谈了15名患者。研究结果表明,参与者认识到与日常生活活动中的身体限制相关的各种结构方面,这导致了四个参考方面。在日常生活中寻找实际解决方案的需求集中在生活必须如何改变以及必须发明其他进行日常生活活动的方式上。对未来抱有现实期望的特点是相信未来本身将以身体功能的变化为特征,但保持功能和活动的动力确保了日常生活的良好质量甚至提高了能力。不相信自己的能力包括认为没有机会提高进行日常生活活动的能力。除了对未来的不确定性之外,还存在对不期望的被动性的认知、对过度劳累或进行可能危及健康的活动的莫名恐惧。在日常生活中失去社会角色方面,参与者描述由于身体能力有限而失去了他们的社交网络以及在社会和家庭中的地位。当失去身体能力时,会出现身心方面重要问题的缺失。总之,慢性心力衰竭患者找到了管理日常生活活动的新方法,包括愿意改变关注点并确定做重要事情的其他方式。患者有动力保持功能和活动,以确保日常生活的良好质量并增强身体能力。对自身身体能力缺乏信任以及在日常生活中感受到的限制使患者无法尝试增加活动。