Östman Malin, Jakobsson Ung Eva, Falk Kristin
Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Närhälsan Källstorp Health Centre, Trollhättan, Region Västra Götaland, Sweden;
Int J Qual Stud Health Well-being. 2015 Dec 28;10:29872. doi: 10.3402/qhw.v10.29872. eCollection 2015.
Living with a chronic disease like chronic heart failure (CHF) results in disruptions, losses, and setbacks in the participants' daily lives that affect health and well-being. By using grounded theory method, we illuminate whether persons with CHF experience discontinuity in life and, if so, what helps them to preserve and strengthen continuity in their daily lives. Thirteen individual interviews and one group interview with five participants, aged 62 to 88 years, were carried out. Through data collection and data analysis, we constructed three concepts that make up a model illustrating the participants' experiences in daily life in relation to corporeality, temporality, and identity: experiences of discontinuity, recapturing approaches, and reconciliation. The first concept, experiences of discontinuity, was constructed from the following categories: the alienated body, the disrupted time, and the threatened self. The second concept, recapturing approaches, consists of categories with continuity creative constructions: repossessing the body, maintaining a façade, seizing the day, restoring the balance of time, and preserving self. These actions are intended to overcome problems and master changes in order to maintain balance in daily life through constructions that recreate normality and predictability. The third concept, reconciliation, was constructed from three categories: feel normal, set to adjust, and be positioned. These categories describe how the participants minimize their experiences of discontinuity by recapturing approaches in order to reconcile with various changes and maintain continuity in daily life. Our findings provide a fresh perspective on continuity that may contribute to the development of significant interventions in continuity of care for persons with CHF. However, continuity requires that healthcare systems support each patient's ability to manage change, reorientation, and adjustment to the new situation in order to make it easier for the patient to create and continue living their daily lives as they desire.
患有慢性心力衰竭（CHF）等慢性疾病会给参与者的日常生活带来干扰、损失和挫折，进而影响其健康和幸福感。通过运用扎根理论方法，我们阐明了CHF患者是否经历生活中的间断性，如果是，那么是什么帮助他们在日常生活中保持并强化连续性。我们对13名年龄在62至88岁之间的参与者进行了个人访谈，并对5名参与者进行了小组访谈。通过数据收集和数据分析，我们构建了三个概念，它们构成了一个模型，用以说明参与者在与身体性、时间性和身份相关的日常生活中的经历：间断性经历、重新捕捉方法和调和。第一个概念“间断性经历”由以下类别构成：异化的身体、被打乱的时间和受到威胁的自我。第二个概念“重新捕捉方法”由具有连续性创造性构建的类别组成：重新掌控身体、维持表象、抓住当下、恢复时间平衡和保持自我。这些行动旨在克服问题并应对变化，以便通过重新创造常态和可预测性的构建来维持日常生活中的平衡。第三个概念“调和”由三个类别构成：感觉正常、准备调整和定位。这些类别描述了参与者如何通过重新捕捉方法来尽量减少他们的间断性经历，以便与各种变化相调和并在日常生活中保持连续性。我们的研究结果为连续性提供了一个新视角，这可能有助于为CHF患者的连续性护理制定重要干预措施。然而，连续性要求医疗保健系统支持每个患者应对变化、重新定位和适应新情况的能力，以便患者更容易按照自己的意愿创造并继续他们的日常生活。
