Living with severe chronic heart failure in palliative advanced home care.
BACKGROUND
Living with severe chronic heart failure (CHF) in palliative care has been little studied.


OBJECTIVE
The aim of this study is to illuminate meaning of living with severe CHF in palliative advanced home care through patients' narratives.


METHODS
Narrative interviews were conducted with 4 patients, tape-recorded and transcribed verbatim. A phenomenological-hermeneutic method was used to interpret the text.


RESULTS
Meaning of living with severe CHF in palliative advanced home care emerged as 'knocking on death's door' although surviving. The course of the illness forces one to live a 'roller coaster life,' with an ongoing oscillation between ups and downs. Making it through the downs breeds a kind of confidence in one's ability to survive and the will to live is strong. Being offered a safety belt in the 'roller coaster' by the palliative advanced home care team evokes feelings of security.


CONCLUSIONS
Meaning of living with severe CHF in palliative advanced home care is on one hand, being aware of one's imminent death, on the other hand, making it through the downs i.e. surviving life-threatening conditions, breed confidence in also surviving the current down. Being constructively dependent on palliative advanced home care facilitates everyday life at home.
Brännström
Margareta
M
Department of Nursing, Umeå University, S-90187, Umeå, Sweden. margareta.brannstrom@nurs.umu.se
Ekman
Inger
I
Norberg
Astrid
A
Boman
Kurt
K
Strandberg
Gunilla
G
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D001294:Attitude to Health; D002908:Chronic Disease; D005239:Fear / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment; D006333:Heart Failure / Q000517:prevention & control / Q000523:psychology*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D008297:Male; D015404:Nursing Methodology Research; D010166:Palliative Care / Q000458:organization & administration / Q000523:psychology*; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012720:Severity of Illness Index; D012934:Social Isolation; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden