title: Life disruption, life continuation: contrasting themes in the lives of African-American elders with advanced heart failure.
abstract: This study addresses the need for more information about how urban African-American elders experience advanced heart failure. Participants included 35 African Americans aged 60 and over with advanced heart failure, identified through records from a community hospital in Detroit, Michigan. Four focus groups (n = 13) and 22 individual interviews were conducted. We used thematic analysis to examine qualitative focus groups and interviews. Themes identified included life disruption, which encompassed the sub-themes of living scared, making sense of heart failure, and limiting activities. Resuming life was a contrasting theme involving culturally relevant coping strategies, and included the sub-themes of resiliency, spirituality, and self-care that helped patients regain and maintain a sense of self amid serious illness. Participants faced numerous challenges and invoked a variety of strategies to cope with their illness, and their stories of struggles, hardship, and resilience can serve as a model for others struggling with advanced illness.
authors.affiliation: School of Social Work, Wayne State University, Detroit, MI, USA. faithhopp@wayne.edu
authors.forename: Faith Pratt
authors.initials: FP
authors.lastname: Hopp
authors.forename: Nancy
authors.initials: N
authors.lastname: Thornton
authors.forename: Lindsey
authors.initials: L
authors.lastname: Martin
authors.forename: Robert
authors.initials: R
authors.lastname: Zalenski
mesh_terms: D000223:Adaptation, Psychological; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017144:Focus Groups; D006333:Heart Failure / Q000208:ethnology* / Q000503:physiopathology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008824:Michigan; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013727:Terminal Care