Dyadic issues in cardiovascular disease| Volume 38, ISSUE 4, P284-291, July 2009

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Addressing spouses' unique needs after cardiac surgery when recovery is complicated by heart failure

Published:January 27, 2009DOI:


      Cardiac surgery places extensive stress on spouses who often are more worried than the patients themselves. Spouses can experience difficult and demanding situations when the partner becomes critically ill.


      To identify, describe, and conceptualize the individual needs of spouses of patients with complications of heart failure after cardiac surgery.


      Grounded theory using a mix of systematic coding, data analysis, and theoretical sampling was performed. Spouses, 10 women and 3 men between 39 and 85 years, were interviewed.


      During analysis, the core category of confirmation was identified as describing the individual needs of the spouses. The core category theoretically binds together three underlying subcategories: security, rest for mind and body, and inner strength. Confirmation facilitated acceptance and improvement of mental and physical health among spouses.


      By identifying spouses' needs for security, rest for mind and body, and inner strength, health care professionals can confirm these needs throughout the caring process, from the critical care period and throughout rehabilitation at home. Interventions to confirm spouses' needs are important because they are vital to the patients' recovery.
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        • The Society of Thoracic Surgeons
        (Accessed: November 5, 2008)
        • Bruckenberger E.
        (Accessed: November 5, 2008)
        • Vánky F.
        • Håkansson E.
        • Svedjeholm R.
        Long-term consequences of postoperative heart failure after surgery for aortic stenosis compared with coronary surgery.
        Ann Thorac Surg. 2007; 83: 2036-2043
        • Alla F.
        • Zannad F.
        • Fillippatos G.
        Epidemiology of acute heart failure syndromes.
        Heart Fail Rev. 2007; 12: 91-95
        • Micik S.
        • Borbasi S.
        Effect of support programme to reduce stress in spouses whose partners 'fall off' clinical pathways post cardiac surgery.
        Aust Crit Care. 2002; 15: 33-40
        • Rantanen A.
        • Kaunonen M.
        • Astedt-Kurki P.
        • Tarkka M.T.
        Coronary artery bypass grafting: social support for patients and their significant others.
        J Clin Nurs. 2004; 13: 158-166
        • Engelman R.
        • Rousou J.A.
        • Flack J.E.
        Fast track recovery of the coronary bypass patient.
        Ann Thorac Surg. 1994; 58: 1742-1746
        • Lenz E.
        • Perkins S.
        Coronary artery bypass graft surgery patients and their family member caregivers: outcomes of a family-focused staged psycho-educational intervention.
        Appl Nurs Res. 2000; 13: 142-150
        • McGaughey J.
        • Harrisson S.
        Understanding the preoperative information needs of patients and their relatives in intensive care units.
        Intensive Crit Care Nurs. 1994; 10: 186-194
        • Theobald K.
        • McMurray A.
        Issues and innovations in nursing practice.
        J Adv Nurs. 2004; 47: 483-491
        • Johansson I.
        Theoretical understanding of the coping approaches and social support experiences of relatives of critically ill patients during the intensive care unit stay and the recovery period at home.
        Dissertation. University, Linköping, Sweden2006 (Report No. 944)
        • Lukkarinen H.
        • Kyngas H.
        Experiences of the onset of coronary artery disease in a spouse.
        Eur J Cardiovasc Nurs. 2003; 2: 189-194
        • Rees J.
        • O'Boyle C.
        • MacDonagh R.
        Quality of life: impact of chronic illness on the partner.
        J Royal Soc Med. 2001; 94: 563-566
        • Bakas T.
        • Pressler S.
        • Johnson E.
        • Nauser J.
        • Shaneyfelt T.
        Family caregiving in heart failure.
        Nurs Res. 2006; 55: 180-188
        • Bendetson J.
        The Well Spouse Foundation.
        Caring. 1994; 13 (6): 43-44
        • Stanley M.J.
        • Frantz R.A.
        Adjustment problems of spouses of patients undergoing coronary artery bypass graft surgery during early convalescence.
        Heart Lung. 1988; 17: 677-682
        • Im K.
        • Belle S.H.
        • Schulz R.
        • Mendelsohn A.B.
        • Chelluri L.
        Prevalence and outcomes of caregiving after prolonged (>48 hours) mechanical ventilation in the ICU.
        Chest. 2004; 125: 597-606
        • Schulz R.
        • Beach S.R.
        Caregiving as a risk factor for mortality: the Caregiver Health Effects Study.
        JAMA. 1999; 282: 2215-2219
        • Christakis N.
        • Allison P.
        Mortality after the hospitalization of a spouse.
        New Engl J Med. 2006; 354: 719-730
        • Davies N.
        Carers' opinions and emotional responses following cardiac surgery: cardiac rehabilitation implications for critical care nurses.
        Intensive Crit Care Nurs. 2000; 16: 66-75
        • Blumer H.
        Symbolic interactionism: perspective and method.
        University of California Press, Berkeley1969
        • Glaser B.
        • Strauss A.L.
        The discovery of grounded theory: strategies for qualitative research.
        Aldine Publishing Company, New York1967
        • Glaser B.
        Doing grounded theory: issues and discussions.
        Sociology Press, Mill Valley, CA1998
        • Glaser B.
        Advances in the methodology of grounded theory.
        Theoretical sensitivity. Sociology Press, Mill Valley, CA1978
        • Mead G.
        Mind, self and society from the standpoint of a social behaviorist.
        The University of Chicago Press, Chicago, IL1967
        • Glaser B.
        The grounded theory perspective III: Theoretical coding.
        Sociology Press, Mill Valley, CA2005
        • Lee L.Y.
        • Lau Y.L.
        Immediate needs of adult family members of adult intensive care patients in Hong Kong.
        J Clin Nurs. 2003; 12: 490-500
        • Azoulay E.
        • Pochard F.
        • Chevret S.
        Family participation in care to the critically ill: opinions of families and staff.
        Intensive Care Med. 2003; 29: 1498-1504
        • Stayt L.C.
        Nurses' experiences of caring for families with relatives in intensive care units.
        J Adv Nurs. 2007; 57: 623-630
        • Engström Å.
        Close relatives of critically ill persons in intensive care: the experiences of close relatives and of critical care nurses.
        Licentiate thesis. Tekniska Universitet, Luleå, Sweden2006 (Report No: 22)
        • Curry S.
        Identifying family needs and stresses in the intensive care unit.
        Br J Nurs. 1995; 4: 15-19
        • Gustafsson B.
        • Pörn I.
        A motivational approach to confirmation: an interpretation of dysphagic patients' experiences.
        Theor Med. 1994; 15: 409-430
        • Eriksson U.
        • Svedlund M.
        Struggling for confirmation–patients' experience of dissatisfaction with hospital care.
        J Clin Nurs. 2007; 16: 438-446
        • Artinian N.
        Stress experience of spouses of patients having coronary artery bypass during hospitalization and 6 weeks after discharge.
        Heart Lung. 1991; 20: 52-59
        • Wiegand D.L.
        Withdrawal of life-sustaining therapy after sudden, unexpected life-threatening illness or injury: interactions between patients' families, healthcare providers, and the healthcare system.
        Am J Crit Care. 2006; 15: 178-187
        • Artinian N.T.
        Spouses' perceptions of readiness for discharge after cardiac surgery.
        Appl Nurs Res. 1993; 6: 80-88
        • Jones C.
        • Skirrow P.
        • Griffiths R.D.
        • Humphris G.H.
        • Ingleby S.
        • Eddleston J.
        • et al.
        Rehabilitation after critical illness: a randomized, controlled trial.
        Crit Care Med. 2003; 31: 2456-2461
        • Okkonen E.
        • Vanhanen H.
        Family support, living alone and subjective health of a patient in connection with a coronary artery bypass surgery.
        Heart Lung. 2006; 35: 234-244
        • Ruiz J.
        • Matthews K.A.
        • Scheier M.F.
        • Schulz R.
        Does who you marry matter for your health?.
        J Pers Soc Psychol. 2006; 91: 255-267
        • Glaser B.
        Basics of grounded theory analysis.
        Sociology Press, Mill Valley, CA1992