Insufficient living: experiences of recovery after infective endocarditis.
BACKGROUND
Infective endocarditis (IE) is a traumatic health event, and recovery is often associated with massive physical deconditioning and reduced quality of life. Patients also report reduced cognitive functioning and are at risk of developing anxiety and depression as well as posttraumatic stress disorder. Although studies have found that survivors of IE have impaired physical functioning and mental health, little is known about patient experiences contributing to these findings.


OBJECTIVE
The aim of this study was to describe patient experiences of recovery after IE.


METHODS
Within a phenomenological-hermeneutical framework, a qualitative interview study was conducted that included 6 men and 5 women (aged 29-86 years). Patients were interviewed 3 to 6 months after discharge. Analysis consisted of 3 levels: naive reading, structured analysis, and critical interpretation and discussion.


RESULTS
The overall concept that emerged was "Insufficient Living." Patients all experienced a life after illness, which was perceived as insufficient. The overall concept can be interpreted in terms of the following 3 themes. The first was "an altered life," where participants described a phase of adaptation to a new life situation, which some perceived as manageable and temporary, whereas others found extremely distressing and prolonged. "Shocking weakness" was experienced physically, cognitively, and emotionally, and although it subsided quickly for a few, most experienced a persisting weakness and felt frustrated about the prolonged recovery phase. In "the road to recovery," support from relatives and healthcare professionals, as well as one's own actions, was emphasized as important in facilitating recovery.


CONCLUSIONS
Recovery after IE is perceived as "Insufficient Living." Patients experience an altered life and shocking weakness, and on the road to recovery, support is needed. Research in follow-up care, supporting patients' ability to cope with potential physical and psycho-emotional consequences of IE, is encouraged as a result of these findings.
Trine Bernholdt Rasmussen, MScN, RN PhD Fellow, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, and PhD Fellow, Department of Cardiology, Gentofte Hospital, Gentofte, Denmark. Ann-Dorthe Zwisler, MD, PhD Cardiologist and Trial Manager, The Heart Centre, Rigshospitalet, Copenhagen University Hospital; Associate Professor, National Institute of Public Health, University of Southern Denmark, Copenhagen; and Chief Physician, Department of Cardiology, Holbæk Hospital, Region of Sealand, Denmark. Philip Moons, PhD, RN Professor, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Denmark, and Professor, Centre for Health Services and Nursing Research, KU Leuven-University of Leuven, Belgium. Selina Kikkenborg Berg, PhD, RN Researcher and Project Manager, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, and Researcher and Project Manager, Department of Cardiology, Gentofte Hospital, Denmark.
Trine Bernholdt
TB
Rasmussen
Ann-Dorthe
AD
Zwisler
Philip
P
Moons
Selina Kikkenborg
SK
Berg
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D004696:Endocarditis / Q000523:psychology*; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function