ERA

Download the full-sized PDF of The Influence of Heart Failure Patients’ Values on Self-Care Decision-MakingDownload the full-sized PDF

Analytics

Share

Permanent link (DOI): https://doi.org/10.7939/R3MG7G89N

Download

Export to: EndNote  |  Zotero  |  Mendeley

Communities

This file is in the following communities:

Graduate Studies and Research, Faculty of

Collections

This file is in the following collections:

Theses and Dissertations

The Influence of Heart Failure Patients’ Values on Self-Care Decision-Making Open Access

Descriptions

Other title
Subject/Keyword
Patients' Values, Self-care, Heart Failure, Concept Analysis, Mixed Methods Systematic Review, Focused Study
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Karimi-Dehkordi, Mehri
Supervisor and department
Clark, Alexander M. (Faculty of Nursing)
Examining committee member and department
Whitfield, Kyle (Faculty of Extension)
Spiers, Jude (Faculty of Nursing)
Department
Faculty of Nursing
Specialization

Date accepted
2017-09-25T10:31:25Z
Graduation date
2017-11:Fall 2017
Degree
Doctor of Philosophy
Degree level
Doctoral
Abstract
Heart failure (HF) is a common, costly, disabling and deadly syndrome. It places a considerable burden on Canadian society and on patients, their families, and the health care system. Self-care behaviors are essential to effective HF management. Adherence to some self-care recommendations, however, is selective – that is, patients may choose certain recommendations but not others. They may be influenced by many factors, such as patients’ belief systems. A core component of these systems, which may influence behaviors, are patients’ values. Values have not been clearly defined or explored in relation to HF self-care behaviors. As a consequence, practical approaches to and models of the self-care decision-making process lack adequate incorporation of individuals’ values. As such, this project seeks to understand the nature and influence of HF patients’ values in relation to self-care decisions. As human behavior is best studied in natural situations, critical realism (CR) was selected the ontological foundation for this project. The lens of CR reveals that individuals live in open complex (“real world”) systems with behavior being influenced by the interplay between different factors in these systems. Using CR helped me to design and choose appropriate approaches for this project in order to generate fundamental knowledge concerning HF patients’ values, and to develop models. To provide the full context and description of my dissertation project, this dissertation offers insights into the background and rationale for the study of patients’ values and self-care behavior in HF patients. This thesis also aims to present manuscripts of three interrelated studies, which are: a concept analysis of HF patients’ values, a systematic review to synthesize evidence, and a qualitative study to examine how HF patients’ values influence their self-care decision-making. iii For the first study, a concept analysis of “patients’ values”, I reviewed 121 papers and books. Based on this work, I defined the concept of patients’ values as meaning core beliefs, which are abstract and subjective in nature, and perceived as very significant to individuals. Values function within a system and the priority of values can be changed under certain circumstances. The second paper reports a mixed-methods systematic review. From this work, two models are proposed: the first conveys how patients’ values are involved in self-care decision-making, while the second addresses what types of patients’ values are involved in self-care decision-making. In the third paper, I identify two types of values, functional and emotional, which influence self-care decisions in HF patients with NYHA class II and III. Each type of values relates to self, others, and health professionals. In addition, this study sheds light on five ways that values are involved in patients’ prioritization of their values in order to make self-care decisions. These three studies may enable nurses and other health professionals to understand HF patients’ values, and how those values affect self-care decision-making. Furthermore, the studies may inform future research to develop self-care models and approaches that enable healthcare professionals to help HF patients in their self-care decision-making based on their values.
Language
English
DOI
doi:10.7939/R3MG7G89N
Rights
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Karimi, M., & Clark, A. M. (2016). How do patients’ values influence heart failure self-care decision-making?: A mixed-methods systematic review. International Journal of Nursing Studies, 59, 89-104. doi:10.1016/j.ijnurstu.2016.03.010.

File Details

Date Uploaded
Date Modified
2017-09-25T16:31:26.533+00:00
Audit Status
Audits have not yet been run on this file.
Characterization
File format: pdf (PDF/X)
Mime type: application/pdf
File size: 5545772
Last modified: 2017:11:08 17:38:37-07:00
Filename: Karimi_Mehri_201709_PhD .pdf
Original checksum: b2678d72c053ff0c39289e7f6488b8eb
Activity of users you follow
User Activity Date