Journal article
"What Were They Thinking?'' Patients' Cognitive Representations of Heart Failure Self-care
Journal of hospice and palliative nursing, Vol.17(3), pp.249-256
06/01/2015
DOI: 10.1097/NJH.0000000000000156
Abstract
Heart failure (HF) is the largest palliative care population in the United States. Self-care patient education is a class I recommendation in HF clinical guidelines. Self-care is a 2-step decision-making process of maintenance and management, yet little is known about the thought processes or cognitive representations used. The purpose of this study was to identify and examine patients' cognitive representations in HF self-care with a unique, theoretically derived approach in a descriptive, exploratory study. Purposive sampling targeted hospitalized HF patients. Open-ended conceptual cognitive mapping approach elicited patient-generated items providing a visual display of cognitive representations. Recruitment continued until no new items were elicited. Thirteen white, primarilymale (n = 11) patients reported 124 items when describing daily HF care. For self-care maintenance, diet, medication, and exercise were the most endorsed items. Patients also added items such as relaxation, distraction, or denial, not part of self-care guidelines. For self-care management, patient's items diverged widely from guidelines. A thematic analysis revealed a majority of the items were existential involving reflecting on their mortality and impact on families. Patients have an internal cognitive map with which they manage their HF. Palliative care nurses need to design care that takes this into account.
Details
- Title: Subtitle
- "What Were They Thinking?'' Patients' Cognitive Representations of Heart Failure Self-care
- Creators
- Harleah G. Buck - Pennsylvania State UniversityLinda McAndrew - Pennsylvania State UniversityJ Nicholas Dionne-Odom - University of AlabamaRachel Wion - Pennsylvania State UniversityBarbara Riegel - Univ Penn, Edith Clemmer Steinbright Chair Gerontol, Nursing, Philadelphia, PA 19104 USA
- Resource Type
- Journal article
- Publication Details
- Journal of hospice and palliative nursing, Vol.17(3), pp.249-256
- Publisher
- Lippincott Williams & Wilkins
- DOI
- 10.1097/NJH.0000000000000156
- ISSN
- 1522-2179
- eISSN
- 1539-0705
- Number of pages
- 8
- Grant note
- National Palliative Care Research Center Career Development Award Penn State College of Nursing Pilot Award Jonas Foundation 5R25CA047888 / University of Alabama at Birmingham Cancer Prevention and Control Training Program
- Language
- English
- Date published
- 06/01/2015
- Academic Unit
- Nursing
- Record Identifier
- 9984370360902771
Metrics
1 Record Views