Kontinuitet som grund för vårdande och hälsa vid hjärtsvikt : patienters, närståendes och sjuksköterskors perspektiv

Sammanfattning: Aim: The overall aim was to examine continuity of care for persons with heart failure from the patients', next of kin's and nurses' perspectives.Methods: This thesis has a caring science approach and consists of four qualitative studies conducted in a health care context. Studies I and II are based on patients' experiences of continuity in heart failure. The data were collected through individual interviews and a group interview that was analysed using the grounded theory method. Study III is based on next of kin's perceptions of continuity of care in heart failure. The data were collected with individual interviews and analysed using a phenomenographic method. Study IV is based on nurses' perceptions of continuity of care for patients with heart failure. The data were collected with focus group interviews and analysed using a phenomenographic method.Results: Continuity of care supports caring and health. To patients, continuity is what connects care and life. Continuity of care creates conditions that support the patient's health processes and vitality; it contributes to the patient being able to maintain continuity in life. To the next of kin, continuity of care contributes to a feeling of being in "good hands". Continuity can be the support that next of kin need to integrate care into their daily life with the patient and to find a balance between responsibility and commitment in the patient's care. Nurses have a unique opportunity to create continuity of care in a way that meets the needs and conditions of both patients and next of kin. When continuity is created based on patients' needs, in a way that is meaningful and relevant to patients' health, continuity contributes to well-being, safety and autonomy for patients and next of kin. Continuity of care also makes it easier for nurses to collaborate with the patients, next of kin and other professionals.Conclusion: Continuity makes care caring. Continuity of care supports patients and next of kin to manage life adaptation that accompanies the disease and preserve their well-being and health as much as possible. Continuity of care supports nurses' professional practice.