What are the needs and experiences of caregivers of people with heart failure? A qualitative study.

BACKGROUND: The global burden of heart failure is estimated to be around 64 million people, with many needing care and support for daily living activities. These needs are usually filled by close relatives, often a spouse, and therefore someone of a similar age to the person for whom they care. OBJECTIVES: The aim of this study was to explore the needs and experiences of caregivers caring for a person with heart failure through a qualitative interview approach. METHODS: A qualitative study was conducted in a large region in South England. 17 caregivers were interviewed using a semi-structured approach and the data analysed using thematic analysis. RESULTS: Four themes were identified from the data: a) Taking on the role of caregiver with the sub-themes of: acceptance and life changes; b) Getting to grips with being a caregiver with sub-themes: carrying out the care and coping with the care; c) Impact on own health and wellbeing: sub-themes of physical health and mental and emotional health and finally: d) Need for information and Support with sub-themes: trying to get knowledge and making sense. CONCLUSIONS: This study has shown that heart failure caregiving can have a negative impact on caregivers' own health and wellbeing and involves complex care delivery for which they receive little support. Caregivers of people with heart failure report having significant information needs in order to understand the reasons for the care they provide yet feel marginalised by health care professionals.

Patient involvement in resuscitation decisions.

The dilemma over whether patients should be involved in resuscitation decisions is a crucial issue as it brings into question some of the fundamental principles on which we base our practice. Nurses have a vital role to play in protecting patients' autonomy.

Exploring the benefits of a subjective approach in qualitative nursing research.

The increasing credibility of qualitative approaches for research in nursing has opened up new debates about methodology and rigour. Traditionally, qualitative methods have been scrutinized using some criteria that are more pertinent for quantitative research. The transition to a more subjective, reflexive approach to nursing research may be painful, but brings benefits. With the loss of scientific rigour comes the gain of eliciting true meaning, by recreating the experiences of others through co-operative enquiry. An openly subjective approach allows the researcher to be a real partner with informants, and to openly use her own experiences and reflections in order to uncover valuable meaning and to find a different type of objectivity. This paper explores some of the issues that are of concern and some of the benefits that may result from an openly subjective approach in qualitative nursing research.