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Family adjustment to heart transplantation: Redesigning the dream
APRIL 1988. VOL. 47, NO 4
AORN JOURNAL
Research Reviews Heart transplants, pacemakers, hypothermia, verbal abuse studied
M H Mishel, C L Murdaugh, “Family adjustment to heart transplantation: Redesigning the dream,”
Nursing Research 36 (November/December 1987) 332-338.
This qualitative research study focused on the processes used by family members of heart transplant recipients to manage the unpredictable events before, during, and after heart transplant surgery. During the study period of 2%years, three family support groups were each followed for 12 weeks; the total sample consisted of 20 family members. The methods used included concurrent data collection, analysis, and coding. In their findings, researchers identified three stages that families go through in the heart transplant process: waiting for a donor, hospitalization, and recovery. They developed their findings into a substantive theory called redesigning the dream. The theory has three concepts: immersion, passage, and negotiation, which correspond to the three stages of waiting, hospitalization, and recovery. As part of their theory, the researchers described how family members’ beliefs and attitudes about organ transplantation changed to adapt to living with the unpredictable circumstances surrounding heart transplants. The detailed discussion of the stages and family processes lends credibility to the study and its findings. Perioperative nursing implications. This study clearly identifies and explains the emotional highs and lows of heart transplantation. On a broader scale, the substantive theory-redesigning the dream-has applications for other surgical
procedures. For example, the perioperative nurse might adapt aspects of this theory to help assess, plan, implement, and evaluate perioperative patient care. This qualitative study is well written and easy to read and understand. It is highly recommended reading for all perioperative nurses. Perioperative nurses new to nursing research will find this study interesting and possibly an incentive to pursue nursing research. ROGERA. STONE,RN, MS, CNOR NURSINGRESEARCHCOMMITTEE D M Lanuza, S F Marotta, “Endocrine and psychologic responses of patients to cardiac pacemaker implantation,” Heart & Lung 16 (September 1987) 496-505. Using structured patient-teaching programs to decrease patients’ feelings of anxiety and distress associated with hospital-related procedures has been proposed by many investigators. In this quasiexperimental study, conducted in a large metropolitan hospital, 28 volunteer patients who required a transvenous, permanent cardiac pacemaker were examined. Researchers tried to ascertain whether the patients’ preoperative and postoperative endocrine and psychologic responses were altered by a structured preoperative pacemaker teaching program. A control group of 14 subjects received the usual unstructured patient teaching from hospital personnel. The teaching was a review of the manufacturer’s pacemaker pamphlet and/or instructional flip chart. Each patient in the
d1021
AORN JOURNAL
Research Reviews Heart transplants, pacemakers, hypothermia, verbal abuse studied
M H Mishel, C L Murdaugh, “Family adjustment to heart transplantation: Redesigning the dream,”
Nursing Research 36 (November/December 1987) 332-338.
This qualitative research study focused on the processes used by family members of heart transplant recipients to manage the unpredictable events before, during, and after heart transplant surgery. During the study period of 2%years, three family support groups were each followed for 12 weeks; the total sample consisted of 20 family members. The methods used included concurrent data collection, analysis, and coding. In their findings, researchers identified three stages that families go through in the heart transplant process: waiting for a donor, hospitalization, and recovery. They developed their findings into a substantive theory called redesigning the dream. The theory has three concepts: immersion, passage, and negotiation, which correspond to the three stages of waiting, hospitalization, and recovery. As part of their theory, the researchers described how family members’ beliefs and attitudes about organ transplantation changed to adapt to living with the unpredictable circumstances surrounding heart transplants. The detailed discussion of the stages and family processes lends credibility to the study and its findings. Perioperative nursing implications. This study clearly identifies and explains the emotional highs and lows of heart transplantation. On a broader scale, the substantive theory-redesigning the dream-has applications for other surgical
procedures. For example, the perioperative nurse might adapt aspects of this theory to help assess, plan, implement, and evaluate perioperative patient care. This qualitative study is well written and easy to read and understand. It is highly recommended reading for all perioperative nurses. Perioperative nurses new to nursing research will find this study interesting and possibly an incentive to pursue nursing research. ROGERA. STONE,RN, MS, CNOR NURSINGRESEARCHCOMMITTEE D M Lanuza, S F Marotta, “Endocrine and psychologic responses of patients to cardiac pacemaker implantation,” Heart & Lung 16 (September 1987) 496-505. Using structured patient-teaching programs to decrease patients’ feelings of anxiety and distress associated with hospital-related procedures has been proposed by many investigators. In this quasiexperimental study, conducted in a large metropolitan hospital, 28 volunteer patients who required a transvenous, permanent cardiac pacemaker were examined. Researchers tried to ascertain whether the patients’ preoperative and postoperative endocrine and psychologic responses were altered by a structured preoperative pacemaker teaching program. A control group of 14 subjects received the usual unstructured patient teaching from hospital personnel. The teaching was a review of the manufacturer’s pacemaker pamphlet and/or instructional flip chart. Each patient in the
d1021