Objective: Little is known about the effects of heart failure on the lives of spousal caregivers.The purpose of this study was to explore the lived experience of wives who were caring for a husband with heart failure, from the perspectives of the wives themselves. Design: The study used a descriptive design that employed qualitative methodology. Sample, Setting, Years: Seven wives who agreed to participate were identified from a Northeastern university heart failure clinic. Each was interviewed three to four times over a six month period or longer. Variable Studied: Wives' were asked to provide descriptions of their caregiving experiences. Methods: A series of in-depth, unstructured interviews were tape-recorded.Wives were asked to describe their experiences in living with a husband who has heart failure, the effects that illness had on their relationships with the ill spouse and significant others, and the quality of their interactions with health care providers. Interviews were analyzed using qualitative methods that employed use of recursive analysis, field logs and analytic memos. Peer review and member checking were utilized to enhance trustworthiness. Findings: Wives described profound effects that living with a husband who has heart failure had on their lives. A metatheme of surviving chaos emerged from the data. Subthemes of contingency, social isolation, and dissociation of self were identified. Wives'experiences of chaos were compounded by inability to find recognition for their suffering. Wives experienced their husbands’ illness as a series of ongoing losses. The pattern of their grief was consistent with the concept of chronic sorrow. Most wives described themselves as despressed. Wives used a variety of cognitive, emotion-focused and problem-solving strategies to cope with their husbands’ illness. Use of protective buffering was common. These wives experienced considerable confusion and anxiety related to the use of advanced directives in the setting of end stage heart failure. Conclusions: The study concluded that women who care for husbands with heart failure may be at high risk for altered psychosocial functioning. Their needs are often inadequately addressed by professional caregivers. Implications: Nurses are in pivotal positions to be instrumental in reducing the stresses associated with living with chronic heart failure. Nurses can contribute to undertanding the use of advanced directives in heart failure. Further study of the relationship between chronic sorrow and depression in patients and their spouses is needed.
Back to Understanding and Supporting Caregivers
Back to The Advancing Nursing Practice Excellence: State of the Science