Mårtensson J, Karlsson J E, Fridlund B
Department of Cardiology, Ryhov County Hospital, Jönköping, Sweden.
J Adv Nurs. 1998 Dec;28(6):1216-24. doi: 10.1046/j.1365-2648.1998.00827.x.
Congestive heart failure (CHF) is a significant health problem for women, particularly elderly women. The risk factors for heart failure appear to be different in women than in men, with hypertension and diabetes playing a greater role in women and ischaemic heart disease a greater role in men. The aim of this study was to describe, from a nurse's perspective, how female patients with CHF conceive their life situation. Interview questions were designed with a focus on five dimensions: biophysical, socio-cultural, emotional, intellectual and spiritual-existential. A qualitative method was used with a phenomenographic approach, as this approach examines aspects of the surroundings as they are conceived. Five categories emerged in the results: feeling content, feeling a sense of support, feeling a sense of limitation, feeling anxiety and feeling powerless. A sense of limitation regarding working capacity and being able to support those in their surroundings causes patients with CHF to experience anxiety due to feeling insecure about themselves and in relation to their surroundings. This may result in feelings of worthlessness in women with CHF, both concerning their own capacity and the fact that they feel they are a burden to those around them. Through nursing intervention, these patients can receive help to break this vicious circle of feeling limited and powerless. This can be done by encouraging them to verbalize their feelings and set realistic goals and expectations, and by increasing their knowledge and that of their families concerning CHF and its symptoms, with a focus on self-care and existing possibilities. These measures will make it easier for women with CHF to maintain a hopeful perspective and a sense of control, competence, and self-esteem.
充血性心力衰竭（CHF）是女性尤其是老年女性面临的一个重大健康问题。心力衰竭的危险因素在女性和男性中似乎有所不同，高血压和糖尿病在女性中作用更大，而缺血性心脏病在男性中作用更大。本研究的目的是从护士的角度描述患有CHF的女性患者如何看待她们的生活状况。访谈问题围绕五个维度设计：生物物理、社会文化、情感、智力和精神存在。采用了定性方法和现象学方法，因为这种方法考察的是人们所感知的周围环境的各个方面。结果出现了五类情况：感到满足、感到有支持感、感到有限制感、感到焦虑和感到无力。工作能力受限以及无法帮助周围的人，使得CHF患者因对自己和周围环境感到不安全而产生焦虑。这可能导致CHF女性患者产生无用感，既涉及她们自身的能力，也涉及她们觉得自己是周围人的负担这一事实。通过护理干预，这些患者可以得到帮助，打破这种感到受限和无力的恶性循环。可以通过鼓励她们说出自己的感受并设定现实的目标和期望，以及增加她们及其家人关于CHF及其症状的知识，重点是自我护理和现有可能性来做到这一点。这些措施将使患有CHF的女性更容易保持充满希望的心态以及控制感、能力感和自尊感。
