The Transition Experience of Spousal Caregivers of Congestive Heart Failure Patients

Wednesday, 24 July 2013

Linda L. Hansen-Kyle, PhD, RN, CCM
Nursing, Azusa Pacific University, San Diego Campus, San Diego, CA
Patricia Roth, EdD, RN
Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA

Learning Objective 1: The learner will be able to describe transition experiences of spousal caregivers of patients with CHF from referral to hospice to 12 months after death

Learning Objective 2: The learner will be able to identify the barriers and support structures to help with this transition process


Congestive Heart Failure (CHF) is becoming epidemic worldwide. Although symptom management is a major issue as patients decline, the inability to predict the terminal phase of CHF leads to decreased referrals to hospice care. Few studies have explored the transition of spouses of patients with CHF on entry to hospice settings through the experience of care giving, death and bereavement. The purpose of this in-process study is to explore the transition experience of spousal caregivers of patients with CHF from the point of hospice referral and terminal decline to 12 months after death. Study aims include: 1) Describe the transition process of the spousal caregiver, and 2) Examine caregiver quality of life, resilience, spirituality, and bereavement over time.


This mixed methods study utilizes qualitative interviews and quantitative scales to uncover the journey of caregivers. Use of qualitative and quantitative methods facilitates triangulation and identifies overlapping components. Grounded theory method and dimensional analysis were selected to uncover the dominant transition process. Audio recorded open-ended spousal interviews are conducted within 4-6 weeks of the patient’s death. Participants are re-interviewed at 3-4, 7-8 and 11-12 months. Interview data are transcribed, coded and analyzed to derive major themes. Participants are asked to complete four scales on quality of life, resilience, spirituality and bereavement at 3-4 and 11-12 months. Descriptive, correlational, and serial measurement techniques will be used to analyze the quantitative data.


Qualitative and quantitative results are compared and integrated for contextual information and interpretation. Preliminary results are not available as data collection is in process.


Results from this research expands the theoretical basis that informs further research of the transition experiences of spousal caregivers. Increased knowledge of spousal caregivers’ transitions during the end of life and bereavement phases will assist health care providers in facilitating this life journey.