Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista

Abstract The purpose of this prospective, clinical longitudinal survey was to describe, explain and understand the subjective quality of life and life course of patients with coronary artery disease. The study subjects' quality of life was assessed at the time of the onset of coronary artery d...

Full description

Bibliographic Details
Main Author: Lukkarinen, H. (Hannele)
Format: Doctoral Thesis
Language:Finnish
Published: University of Oulu 1999
Subjects:
Online Access:http://urn.fi/urn:isbn:9514254627
http://nbn-resolving.de/urn:isbn:9514254627
id ndltd-oulo.fi-oai-oulu.fi-isbn951-42-5462-7
record_format oai_dc
collection NDLTD
language Finnish
format Doctoral Thesis
sources NDLTD
topic bypass surgery
coronary artery disease
life course
quality of life
self-care
transluminal angioplasty
spellingShingle bypass surgery
coronary artery disease
life course
quality of life
self-care
transluminal angioplasty
Lukkarinen, H. (Hannele)
Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
description Abstract The purpose of this prospective, clinical longitudinal survey was to describe, explain and understand the subjective quality of life and life course of patients with coronary artery disease. The study subjects' quality of life was assessed at the time of the onset of coronary artery disease, during the treatment process and during rehabilitation. Altogether 280 patients participated, of whom 80 were treated with medication, 100 with transluminal angioplasty, and 100 with bypass surgery. The study population consisted of 189 men and 91 women. At the baseline, the study subjects' self-care agency was measured with the Self-As-Carer Inventory (SCI). The subjects health-related quality of life was assessed with the Nottingham Health Profile (NHP) at the baseline as well as at 6 and 12 months after the procedure. The qualify of life of coronary artery disease patients was compared to the quality of life of an age- and sex-matched Finnish adult population (N = 3600) by using a previous standardisation of the NHP instrument. One year after the treatment, 19 patients who had undergone either bypass surgery or angioplasty attended thematic interviews at their homes. Triangulation of methodologies, methods and data collection was used in the study. The qualitative analysis of personal experiences was carried out using the method of phenomenological psychology described by Amedeo Giorgi based on Husserl's descriptive phenomenology. Before the treatment procedures, the quality of life of the coronary artery disease patients was significantly poorer than that of the age-matched adult population on the dimensions of energy, pain, emotional reactions, sleep and mobility. Moreover, the female patients with coronary artery disease had poorer health-related quality of life than the corresponding male patients, especially on the dimensions of energy, sleep, emotional reactions and mobility. The quality of life of the patients who had undergone angioplasty or bypass surgery was statistically significantly better one year after surgery on the dimensions of energy, pain and mobility. Their quality of life had, however, deteriorated on the dimensions of emotional reactions and social isolation. The thematic interviews revealed two kinds of life course: one with an active attitude towards treatment and a re-orientation of life course and another with a passive attitude towards treatment and a maintenance of the old principles in one's life course. A need for rehabilitation was indicated by an onset of the illness suddenly at a relatively young age, termination of an active working career, financial problems, dissatisfaction with the outcome of treatment, problems in family relations, and a desolate view of the future. An increased need for psychosocial support was especially common among women, subjects with recurrence and both male and female subjects in the youngest age group. According to the subjects, after-care failed to meet their needs or to address their problems. No continuous and confidential therapeutic relationships emerged. The problems included inadequate knowledge of one's condition and a lack of detailed instructions concerning the permissible degree of exertion after treatment. The patients felt they needed rehabilitation groups with coronary artery disease patients similar to themselves. The study yielded new knowledge about the health-related quality of life of coronary artery disease patients, the connections between the treatment methods and the changes in the patients' quality of life during one year and the patients' experiences at the time of the diagnosis and during the periods of treatment and after-care. This evidence-based knowledge can be used to develop the treatment and rehabilitation of coronary artery disease patients and to plan further research.
author Lukkarinen, H. (Hannele)
author_facet Lukkarinen, H. (Hannele)
author_sort Lukkarinen, H. (Hannele)
title Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
title_short Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
title_full Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
title_fullStr Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
title_full_unstemmed Sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
title_sort sepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksista
publisher University of Oulu
publishDate 1999
url http://urn.fi/urn:isbn:9514254627
http://nbn-resolving.de/urn:isbn:9514254627
work_keys_str_mv AT lukkarinenhhannele sepelvaltimotautiasairastavienelamanlaatujaelamankulkupitkittaistutkimuslaakkeillapallolaajennuksellataiohitusleikkauksellahoidettujenkokemuksista
_version_ 1718554647386390528
spelling ndltd-oulo.fi-oai-oulu.fi-isbn951-42-5462-72017-10-14T04:17:43ZSepelvaltimotautia sairastavien elämänlaatu ja elämänkulku:pitkittäistutkimus lääkkeillä, pallolaajennuksella tai ohitusleikkauksella hoidettujen kokemuksistaLukkarinen, H. (Hannele)info:eu-repo/semantics/openAccess© University of Oulu, 1999info:eu-repo/semantics/altIdentifier/pissn/0355-3221info:eu-repo/semantics/altIdentifier/eissn/1796-2234bypass surgerycoronary artery diseaselife coursequality of lifeself-caretransluminal angioplasty Abstract The purpose of this prospective, clinical longitudinal survey was to describe, explain and understand the subjective quality of life and life course of patients with coronary artery disease. The study subjects' quality of life was assessed at the time of the onset of coronary artery disease, during the treatment process and during rehabilitation. Altogether 280 patients participated, of whom 80 were treated with medication, 100 with transluminal angioplasty, and 100 with bypass surgery. The study population consisted of 189 men and 91 women. At the baseline, the study subjects' self-care agency was measured with the Self-As-Carer Inventory (SCI). The subjects health-related quality of life was assessed with the Nottingham Health Profile (NHP) at the baseline as well as at 6 and 12 months after the procedure. The qualify of life of coronary artery disease patients was compared to the quality of life of an age- and sex-matched Finnish adult population (N = 3600) by using a previous standardisation of the NHP instrument. One year after the treatment, 19 patients who had undergone either bypass surgery or angioplasty attended thematic interviews at their homes. Triangulation of methodologies, methods and data collection was used in the study. The qualitative analysis of personal experiences was carried out using the method of phenomenological psychology described by Amedeo Giorgi based on Husserl's descriptive phenomenology. Before the treatment procedures, the quality of life of the coronary artery disease patients was significantly poorer than that of the age-matched adult population on the dimensions of energy, pain, emotional reactions, sleep and mobility. Moreover, the female patients with coronary artery disease had poorer health-related quality of life than the corresponding male patients, especially on the dimensions of energy, sleep, emotional reactions and mobility. The quality of life of the patients who had undergone angioplasty or bypass surgery was statistically significantly better one year after surgery on the dimensions of energy, pain and mobility. Their quality of life had, however, deteriorated on the dimensions of emotional reactions and social isolation. The thematic interviews revealed two kinds of life course: one with an active attitude towards treatment and a re-orientation of life course and another with a passive attitude towards treatment and a maintenance of the old principles in one's life course. A need for rehabilitation was indicated by an onset of the illness suddenly at a relatively young age, termination of an active working career, financial problems, dissatisfaction with the outcome of treatment, problems in family relations, and a desolate view of the future. An increased need for psychosocial support was especially common among women, subjects with recurrence and both male and female subjects in the youngest age group. According to the subjects, after-care failed to meet their needs or to address their problems. No continuous and confidential therapeutic relationships emerged. The problems included inadequate knowledge of one's condition and a lack of detailed instructions concerning the permissible degree of exertion after treatment. The patients felt they needed rehabilitation groups with coronary artery disease patients similar to themselves. The study yielded new knowledge about the health-related quality of life of coronary artery disease patients, the connections between the treatment methods and the changes in the patients' quality of life during one year and the patients' experiences at the time of the diagnosis and during the periods of treatment and after-care. This evidence-based knowledge can be used to develop the treatment and rehabilitation of coronary artery disease patients and to plan further research. University of Oulu1999-11-22info:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://urn.fi/urn:isbn:9514254627urn:isbn:9514254627fin