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Life situation in people with peripheral arterial disease and their family members
Sophiahemmet University.
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Life with peripheral arterial disease and the resulting impaired walking ability leads to major limitations in daily life and a decreased quality of life. The overall aim of this thesis was to generate understanding about the life situation among people living with peripheral arterial disease and their family members. The outcomes after percutaneous transluminal angioplasty interventions both proximal and distal to the inguinal ligament were assessed by collecting data by means of chart review using a study specific protocol. The results show a connection between proximal intervention and age as well as proximal intervention and smoking. Patients in the proximal group were younger and more frequent smokers or former smokers and hematomas/bruises as a complication were more common among non-diabetic patients (Paper I). Health related quality of life in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty intervention was investigated using a general questionnaire (EQ5D) as well as a disease-specific questionnaire (CLAU-S) translated into Swedish for this study. The health related quality of life was improved both one month and one year after the percutaneous transluminal angioplasty compared to before the intervention (Paper II). The experiences of living with intermittent claudication were studied through qualitative interviews with individuals suffering from peripheral arterial disease. The interviews were analyzed by thematic content analysis and six themes together founded a main theme concerning adjusting to a restricted life when living with intermittent claudication (Paper III). Spouses and cohabitants were interviewed about their experiences of living together with a person suffering from intermittent claudication. The overall theme was about living a demanding life when living together with someone with intermittent claudication. The findings of this study give insight into the complexities and the difficulties of ageing and living together with someone suffering from intermittent claudication (Paper IV). In conclusion, living with intermittent claudication has a major impact on daily life and demands adjustment to a restricted life. Percutaneous transluminal angioplasty improves health related quality of life among individuals suffering from peripheral arterial disease and the effect is sustainable over time up to one year after the intervention. People who had undergone percutaneous transluminal angioplasty were younger in the proximal group and hematomas/bruises were more common among nondiabetic patients. Ageing and intermittent claudication have great impact on both the spouse’s and the ill person’s life situation

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet , 2011. , 45 p.
Keyword [en]
Peripheral vascular disease, Experiences, Angioplasty, balloon, Health related quality of life, Life situation, Family members
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-894ISBN: 978-91-7457-501-9 (print)OAI: oai:DiVA.org:shh-894DiVA: diva2:461077
Public defence
2011-12-02, Erforssalen, Sophiahemmet Högskola, Lindstedtsvägen 8, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2011-12-02 Created: 2011-11-11 Last updated: 2016-06-09Bibliographically approved
List of papers
1. Percutaneous transluminal angioplasty between 1998 and 2002: outcomes of interventions proximal and distal to the inguinal ligament
Open this publication in new window or tab >>Percutaneous transluminal angioplasty between 1998 and 2002: outcomes of interventions proximal and distal to the inguinal ligament
2008 (English)In: Open Access Surgery, ISSN 1178-7082, Vol. 1, 9-19 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to examine patients who have undergone percutaneous transluminal angioplasty (PTA) in order to describe patient characteristics and outcomes of interventions proximal and distal to the inguinal ligament and to assess whether different living situations may be associated with the outcome of PTA-intervention.

Design: A retrospective descriptive chart review.

Setting: A Swedish University Hospital between January 1998 and December 2002.

Participants: All patients who have undergone PTA.

Main outcome measure: Medical and nursing records from medical, surgical, orthopedic, and geriatric clinics were reviewed to obtain data. A study-specific protocol was developed.

Results: Eighty-seven patients were treated with PTA proximal and 101 distal to the inguinal ligament. No significant differences regarding outcome were found. Fifty-two patients had hematoma/bruise as a complication, which was more common among non-diabetic patients; 46 without diabetes versus 6 diagnosed with diabetes (p = 0.001). When comparing patients living situations and mortality, 76 of the deceased patients had been living alone compared to 38 of the survivors (p = 0.001).

Conclusions: The patients were younger in the proximal group, however no differences in outcome were found between patients who had undergone PTA whether proximal or distal to the inguinal ligament. Hematomas/bruises as a complication were more common among nondiabetic patients. Amputation was a strong predictor of death during follow-up.

Place, publisher, year, edition, pages
Shanghai: Dove Medical Press, 2008
Keyword
Angioplasty, Balloon, Peripheral vascular diseases, Treatment outcome, Perkutan transluminal angioplastik (PTA), Perifer arteriell sjukdom
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-2 (URN)
Available from: 2010-03-02 Created: 2010-02-12 Last updated: 2014-09-12Bibliographically approved
2. Health-related quality of life in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty: a prospective one-year follow-up
Open this publication in new window or tab >>Health-related quality of life in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty: a prospective one-year follow-up
2010 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 28, no 2, 72-7 p.Article in journal (Refereed) Published
Abstract [en]

Measuring Health Related Quality of Life has become more and more important in evaluating patients with peripheral arterial disease. This prospective longitudinal survey aimed to investigate health related quality of life over time in patients with peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA) between December 2005 and June 2008. Health Related Quality of life was assessed using the Claudication Scale (CLAU-S) and EQ5D and the Sense of Coherence Scale was used to estimate the patients' sense of coherence. The findings of this study shows that the total CLAU-S score was improved both at one-month follow-up (p < 0.0001) and one-year follow-up (p < 0.0001) compared to baseline. There were significant differences regarding all five dimensions: every day life, pain, social life, illness-specific fears and psychological wellbeing. The EQ5D computed by index improved significantly both at one-month follow-up (p = 0.0006) and one-year follow-up (p = 0.0019) compared to baseline. Differences were found between the groups with low and moderate sense of coherence (p = 0.0169) as well as between the groups with low and high sense of coherence (p = 0.0208) regarding health related quality of life (HRQoL). This study showed that PTA improves HRQoL among individuals suffering from PAD and that the effect is sustainable over time. For more accurate results, a disease-specific instrument should be used to evaluate HRQoL.

Keyword
Angioplasty, Balloon, Peripheral vascular diseases, Quality of life, Perkutan transluminal angioplastik (PTA), Perifer arteriell sjukdom, Hälsorelaterad livskvalitet
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-318 (URN)10.1016/j.jvn.2010.02.001 (DOI)20494298 (PubMedID)
Available from: 2011-03-01 Created: 2011-03-01 Last updated: 2014-09-12Bibliographically approved
3. Experiences of living with intermittent claudication
Open this publication in new window or tab >>Experiences of living with intermittent claudication
2012 (English)In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 30, no 1, 5-10 p.Article in journal (Refereed) Published
Abstract [en]

Intermittent claudication is a symptom caused by peripheral arterial disease (PAD) and is associated with pain, impaired mobility and loss of control. Walking ability is reduced due to the pain, and both physical and social functions are often negatively affected, which may lead to patients feeling they are a burden to others. An interview study using a qualitative descriptive design to describe experiences of living with intermittent claudication caused by PAD was carried out during Winter and Spring 2009/2010. Fifteen people suffering from intermittent claudication were interviewed, and the interviews were analyzed using qualitative thematic analysis. Intermittent claudication greatly affects daily living. Six themes were identified: "Experiencing discomfort in the legs," "Moving around in a new way," "Feeling inconvenient when forced to stop," "Missing previous life," "Incorporating intermittent claudication in daily life," and "To lead a strenuous life." The main theme was "Adjusting to a restricted life." The findings show that intermittent claudication has a major impact on daily life. Apart from the severity of symptoms, how the illness is experienced differs among patients, depending on how active the ill person is or wants to be. These findings suggest that increased knowledge about living with intermittent claudication is important to understand the effects on the ill person's life, as a complement to physical examinations when planning individual treatment.

Keyword
Intermittent claudication, Peripheral vascular disease, Experiences, Life situation
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-892 (URN)10.1016/j.jvn.2011.11.001 (DOI)22321401 (PubMedID)
Available from: 2011-11-11 Created: 2011-11-11 Last updated: 2014-09-29Bibliographically approved
4. Living a demanding life - spouses' experiences of living with a person suffering from intermittent claudication
Open this publication in new window or tab >>Living a demanding life - spouses' experiences of living with a person suffering from intermittent claudication
2013 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 3, 610-618 p.Article in journal (Refereed) Published
Abstract [en]

Aim.  To report a study of family members’ experiences of living with a person suffering from intermittent claudication caused by peripheral arterial disease.

Background.  Intermittent claudication is a symptom caused by peripheral arterial disease. Walking ability is reduced due to pain and this also affects the family members and leads to consequences such as isolation and a restricted life.

Design.  This study has a qualitative descriptive design.

Methods.  Ten spouses living with a person suffering from intermittent claudication were interviewed between December 2009–June 2010. The interviews were then analysed using qualitative thematic analysis.

Findings.  Four themes were identified: ‘Frustrating to not meet intentions’, ‘Undergoing changes in social life’, ‘Being a person on the side of things’ and ‘Intertwining of circumstances’. The overall theme ‘Living a demanding life’ illustrates that intermittent claudication has great impact on daily life among spouses.

Conclusion.  This study gives an insight into the complexities and the difficulties of living together with someone suffering from intermittent claudication, a symptom that has great impact on both the spouses’ and the ill persons’ lives. According to the findings in this study, it is important to gain knowledge about the spouses’ experiences because an holistic perspective is essential to treat and support the ill persons and their spouses.

Keyword
Experiences, Family members, Intermittent claudication, Nursing, Peripheral vascular diseases
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-893 (URN)10.1111/j.1365-2648.2012.06043.x (DOI)22616826 (PubMedID)
Available from: 2011-11-11 Created: 2011-11-11 Last updated: 2014-09-29Bibliographically approved

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