A New Normality Illuminated by Past and Present! A Qualitative Study: Experiences and Challenges of Everyday Life in Patients With Advanced Heart or Lung Failure.

The aim of this study was to gain insight into the phenomena of everyday life as experienced and coped with by patients living with advanced heart or lung failure. We employed a qualitative design using a phenomenological hermeneutic approach. Data derived from 10 nursing consultations in a holistic setting. Ricoeur's theory of interpretation inspired the text analysis. The study emphasizes time (past, present, and future) as an overall everyday life theme, playing an essential role associated with improvements or poor outcomes related to physical, mental, and intersubjective challenges. Patients accepted and lived with the challenges, experiencing changes, as transition, but also coped with their new normal, which involved improvements or poor outcomes, some invisible to the community. Assumptions about everyday life changed significantly, the changes possibly essential for intersubjective relations. A reflective approach, can help patients to evolve, using knowledge from the past and present to cope with the future.

Diary for self-observation: A self-management tool for recipients of lung transplantation-A pilot study.

Aim: To (a) explore how the diary contributes to patient motivation for monitoring self-management and (b) explore the nurses' experience of how the diary supports the patients' self-management after lung transplantation. Design: A quantitative and qualitative study design. Methods: Fifteen patients and four nurses participated. Data were analysed descriptively and thematically. Results: This pilot study shows that the diary strengthens patients' self-management in the first postoperative period. Nurses were confident that the patients were structured about self-observation when using the diary.

Patients' perspective of attending nursing consultations-A pilot and feasibility study.

Aim: The aims were to explore: (a) how patients with advanced heart and lung failure accept the overall framework of the nursing consultations and (b) the patients' acceptability and applicability of the nursing consultations. Design: Qualitative study. Methods: Interviews were conducted in an holistic frame and analysed using Graneheim and Lundman's qualitative content thematic analysis. Patients were interviewed between April and May 2018 regarding their general view of the nursing consultation and their experience of the framework inspired by R. R. Parse. Results: The overall theme was A confidential moment with the nurse to deal with and become more aware of what is important, based on following subthemes: "An option that makes sense," "Scheduled time with the nurse is important" and "To find a new normality in everyday life." The framework addressed a space of freedom requested by the informants, for whom attending nursing consultations was useful and meaningful, enabling them to reflect on everyday challenges.

Life after a lung transplant: a balance of joy and challenges.

AIM AND OBJECTIVE: To describe patients' experiences throughout the first four months post-lung transplant. BACKGROUND: Health professionals are familiar with the fact that patients' average survival after a lung transplant is about seven years and that 74% of these patients reject new organs within the first two years. By contrast, knowledge of these patients' perspectives after lung transplantation is scant. DESIGN/METHOD: A qualitative study was conducted between May 2013-May 2014 in which 26 interviewees participated - four months post-transplant - based on a semistructured interview guide. The data were inductively analysed using a content thematic approach within a phenomenological and hermeneutic frame. RESULTS: The main findings in the study reveal that (1) having a lung transplant is an overwhelming experience, which for some patients includes (2) troubling physical and psychological challenges. The interviewees were happy to get another chance to live, although some of them suffered from medical side effects, postoperative complications and psychological problems. When asked about the future, interviewees stated that life could be described as (3) a balance of joy and challenges. They had received a new chance in life and were eager to fulfil their life hopes and dreams. At the same time, they were worried about the future. Having a lung transplant implies rules that have to be followed. What are the healthy choices they are supposed to make? And will there be a tomorrow? CONCLUSIONS: Having a lung transplant is described as an overwhelming experience because of the improvement in the physical function of the body. Patients were grateful to family, friends and healthcare professionals for supporting them. The first four months post-transplantation were described as both physically and psychologically challenging. Interviewees were aware of the prognosis for patients following lung transplantation. They expressed feelings of worry and insecurity but still had hopes and dreams. RELEVANCE TO CLINICAL PRACTICE: The patients are troubled by both physical and psychological challenges after lung transplantation. Several areas call for interventions from healthcare professionals during the early post-transplant period.

Patient engagement and self-management in pulmonary arterial hypertension.

Improved care in pulmonary arterial hypertension has led to increased longevity for patients, with a paralleled evolution in the nature of their needs. There is more focus on the impact of the disease on their day-to-day activities and quality of life, and a holistic approach is coming to the front of pulmonary arterial hypertension management, which places the patient at the centre of their own healthcare. Patients are thus becoming more proactive, involved and engaged in their self-care, and this engagement is an important factor if patient outcomes are to improve. In addition, involvement of the patient may improve their ability to cope with pulmonary arterial hypertension, as well as help them to become effective in the self-management of their disease. Successful patient engagement can be achieved through effective education and the delivery and communication of timely, high-quality information. A multidisciplinary approach involving healthcare professionals, carers, patient associations and expert patient programmes can also encourage patients to engage. Strategies that promote patient engagement can help to achieve the best possible care and support for the patient and also benefit healthcare providers.