title: Impact of cardiac disease on couples' relationships.
abstract: OBJECTIVE
  This paper reports a study to describe meanings that couples mutually assign to, and practices they develop, after the onset of cardiac disease and to understand the impact of the illness on the couples' relationships in everyday life.
  
  
  BACKGROUND
  Patients as well as partners are affected by the onset of cardiovascular disease. Social support within intimate relationships has been shown to be important for patient survival and well-being, and couples' coping strategies are pivotal for well-being and adjustment to the chronic condition in both patients with cardiovascular disease and their partners.
  
  
  METHODS
  Twenty-four couples participated in this phenomenological study. Data were collected during 2003. Participants were interviewed after having been hospitalized due to an acute event and having participated in a rehabilitation programme. Three in-depth interviews were obtained for each dyad: one couple interview and two individual interviews with each partner of the dyad. Paradigm cases were sought and thematic analyses conducted.
  
  
  RESULTS
  All couples experienced a 'brush with death' at the onset of heart disease, which called for changes in lifestyle. Three distinct patterns of dealing with the illness emerged. The first revealed that some couples assess the illness as a positive, transformative experience in their lives, bringing them closer together. The second showed that a proportion of couples experience the illness as a threat which imposes fear on both partners. The challenges are faced as mutual tasks and new routines are developed. The third pattern revealed couples who experience a missed opportunity to change. These couples are disenchanted about each other but return to life as usual.
  
  
  CONCLUSIONS
  Nurses can use the information gained from this study to support couples in their attempts to come to terms with the illness, and can enhance their supportive role in rehabilitation efforts.
authors.affiliation: Romy Mahrer-Imhof PhD RN Research Associate Nursing Faculty, Institute of Nursing Science, University of Basel, Basel, Switzerland. romy.mahrer@unibas.ch
authors.forename: Romy
authors.initials: R
authors.lastname: Mahrer-Imhof
authors.forename: Andreas
authors.initials: A
authors.lastname: Hoffmann
authors.forename: Erika Sivarajan
authors.initials: ES
authors.lastname: Froelicher
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003376:Counseling / Q000379:methods* / Q000592:standards; D005260:Female; D006331:Heart Diseases / Q000451:nursing / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged