TY - JOUR
T1 - The ‘work’ of self-care for people with cardiovascular disease and prediabetes
T2 - An interpretive description
AU - van Wissen, Kim
AU - Blanchard, Denise
PY - 2020/2/12
Y1 - 2020/2/12
N2 - Background: Cardiovascular disease and sustained high blood glucose (prediabetes) are established concurrent diagnoses. People with these concomitant conditions carry out self-care which is overt (e.g., daily weighing or taking a specific diet), plus there are also concealed facets of self-care (e.g., accessing information about diet or medications). Also of note is the need to 'work' to achieve a self-determined level of self-care. The 'work' put into self-care is currently under-reported when people discuss their progress with health professionals. Objective: Our research aimed to demonstrate that aspects of self-care are typically concealed. A further objective was to reveal the extent of 'work' dedicated to self-care. Design: Interviews were conducted with 23 participants to reveal their experiences of long-term conditions, cardiovascular disease and prediabetes. Interpretive description underpinned the development of a thematic representation of the data. Setting and participants: Recruitment was from a tertiary hospital coronary care unit in New Zealand. Included participants were those with an acute coronary event, also found to have a high blood glucose. Those people known to have diabetes prior to admission were not included. Method: Participants were interviewed once, for approximately 60 min, nine months after discharge home. The data is analysed using thematic analysis, organising an interpretation into themes. Results: Self-care requires 'work', the work itself was frequently understated by participants, they trivialised their important role in their self-care. Participants often required prompting to discuss the responsibilities, choices and behaviours they participated in to support self-care to improve their health and well-being. Participant data showed how the 'work' of self-care aligned to three work themes: solo self-care, teamwork, and constant companion self-care. Conclusion: Nurses can improve the outcomes for people with long-term conditions by acknowledging and incorporating the often concealed 'work' of self-care when assessing, planning and implementing health care in any clinical setting. A important recommendation for nurses is to support people-as-patients, by encouraging self-determination and working with the preferences patients have for self-care, in order to enhance their quality of life while living with ill-health.
AB - Background: Cardiovascular disease and sustained high blood glucose (prediabetes) are established concurrent diagnoses. People with these concomitant conditions carry out self-care which is overt (e.g., daily weighing or taking a specific diet), plus there are also concealed facets of self-care (e.g., accessing information about diet or medications). Also of note is the need to 'work' to achieve a self-determined level of self-care. The 'work' put into self-care is currently under-reported when people discuss their progress with health professionals. Objective: Our research aimed to demonstrate that aspects of self-care are typically concealed. A further objective was to reveal the extent of 'work' dedicated to self-care. Design: Interviews were conducted with 23 participants to reveal their experiences of long-term conditions, cardiovascular disease and prediabetes. Interpretive description underpinned the development of a thematic representation of the data. Setting and participants: Recruitment was from a tertiary hospital coronary care unit in New Zealand. Included participants were those with an acute coronary event, also found to have a high blood glucose. Those people known to have diabetes prior to admission were not included. Method: Participants were interviewed once, for approximately 60 min, nine months after discharge home. The data is analysed using thematic analysis, organising an interpretation into themes. Results: Self-care requires 'work', the work itself was frequently understated by participants, they trivialised their important role in their self-care. Participants often required prompting to discuss the responsibilities, choices and behaviours they participated in to support self-care to improve their health and well-being. Participant data showed how the 'work' of self-care aligned to three work themes: solo self-care, teamwork, and constant companion self-care. Conclusion: Nurses can improve the outcomes for people with long-term conditions by acknowledging and incorporating the often concealed 'work' of self-care when assessing, planning and implementing health care in any clinical setting. A important recommendation for nurses is to support people-as-patients, by encouraging self-determination and working with the preferences patients have for self-care, in order to enhance their quality of life while living with ill-health.
UR - http://www.scopus.com/inward/record.url?scp=85081336945&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85081336945&partnerID=8YFLogxK
U2 - 10.1016/j.ijnurstu.2020.103548
DO - 10.1016/j.ijnurstu.2020.103548
M3 - Article
C2 - 32143811
AN - SCOPUS:85081336945
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
SN - 0020-7489
M1 - 103548
ER -