Perceptions of how sleep is influenced by rest, activity and health in patients with coronary heart disease: a phenomenographical study.
OBJECTIVE
A framework is needed for identifying internal and external factors essential for the nursing management of psychological supportive health care and education for patients' self-care in sleep. In order to generate more knowledge from the patient's perspective, the aim of this study was to describe how patients with coronary artery disease (CAD) perceive that their sleep is influenced by rest, activity and health in outpatient care.


METHODS
Qualitative interviews were performed with 33 outpatients.


METHODS
The data were analysed using a phenomenographic method.


RESULTS
Three descriptive categories of the phenomenon were described: my lifestyle is reflected in my sleep behaviour; handling the practices around tiredness and sleep; and feelings of negative and positive efficacy. Feelings of tiredness, fatigue and sleepiness were different pre-sleep stages, but were also related to the patient's adaptation and recovery. Creating one's own personal time and feelings of efficacy gave an inner sense of strength which is indicated as being particularly important in managing stress and the demands of everyday life in a satisfactory manner.


CONCLUSIONS
From a contextual, holistic perspective on health, it is important to identify the patient's needs, symptoms and intentional or unintentional self-care management strategies regarding sleep and lifestyle. To promote a positive health outcome it is essential to identify sleeplessness behaviour and perceived self-efficacy for self-care in sleep.
Johansson
Anna
A
Department of Cardiology, Skövde Hospital, Skövde, Sweden. anjo.tibro@compaqnet.se
Windahl
Maria
M
Svanborg
Eva
E
Fredrichsen
Maria
M
Swahn
Eva
E
Uhlin
Pia Yngman
PY
Edéll-Gustafsson
Ulla
U
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003327:Coronary Disease / Q000150:complications / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015404:Nursing Methodology Research; D036301:Qualitative Research; D012146:Rest / Q000523:psychology*; D012307:Risk Factors; D012648:Self Care / Q000379:methods / Q000523:psychology; D020377:Self Efficacy; D012893:Sleep Wake Disorders / Q000209:etiology / Q000517:prevention & control / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control / Q000523:psychology; D011795:Surveys and Questionnaires; D013548:Sweden