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A phenomenological construct of caring among spouses following acute coronary syndrome

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Abstract

The aim of this study was interpret the existential construct of family caring following Acute Coronary Syndrome. Family support is known to have a positive impact on recovery and adjustment after cardiac events. Few studies provide philosophically-based, interpretative explorations of carer experience following a spouse’s ischaemic event. As carer experiences, behaviours and meaning-making may impact on the quality of the support they provide to patients, further understanding could improve both patient outcomes and family experience. Fourteen spouses of people experiencing Acute Coronary Syndrome in Sydney, Australia were engaged in a single, semi-structured interview. Interviews were audio-recorded and transcribed verbatim. Data were analysed using hermeneutic interpretation within a Heideggerian phenomenological framework. Acute Coronary Syndrome disrupts lived temporality, and the projected potential for carers’ being-alongside. Carers experienced an existential uncertainty that arose from difficulty in diagnosis, and situated fear as an attuned, being-towards-death. They constructed protective strategies to insulate their partner and themselves from further stress and risk, however, unclear boundaries for protection heightened carer anxiety. The existential structure of care included one of two possible Heideggerian modes: leaping-in care was a dominating mode that required a high level of carer vigilance; leaping-ahead care was a metaphorical walking alongside, as carers gave back control, freeing opportunities for the person to ‘own’ care. Supporting carers through the intensive phase of leaping-in care, and equipping them for informed leaping-ahead care should be a focus in both the acute and post-discharge care phases.

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Notes

  1. Heideggerian references use pagination from the original German text. This allows ready reference to any of the English translations which have German pagination listed in the margins.

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Acknowledgements

We would like to acknowledge the invaluable contribution of our participants who gave their time and stories so freely. We would also like to acknowledge funding support from (1) Caring for Carers: A Better Practice Project Grant (Carers Program, Sydney South West Area Health Service) (2) A Nursing Innovations Grant (Sydney South West Area Health Service); and (3) Summer Scholars Program, Sydney Nursing School, University of Sydney.

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Authors and Affiliations

  1. Sydney Nursing School, University of Sydney & Sydney Local Health District., C4:18, MO2, Sydney, NSW, 2006, Australia

    Janice Gullick

  2. Liverpool Hospital, CB3F, Clinical Building, Cnr Goulburn & Elizabeth St, Liverpool, NSW, Australia

    Mark Krivograd

  3. Concord Repatriation General Hospital, Level 7, Burns Unit, Hospital Road, Concord West, Concord, NSW, 2139, Australia

    Susan Taggart

  4. Concord Repatriation General Hospital, 3 West Cardiology, Hospital Road, Concord West, Concord, NSW, 2139, Australia

    Susana Brazete & Lise Panaretto

  5. Sydney Nursing School, University of Sydney, MO2, Sydney, NSW, 2006, Australia

    John Wu

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  1. Janice Gullick
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  2. Mark Krivograd
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Correspondence to Janice Gullick.

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Gullick, J., Krivograd, M., Taggart, S. et al. A phenomenological construct of caring among spouses following acute coronary syndrome. Med Health Care and Philos 20, 393–404 (2017). https://doi.org/10.1007/s11019-017-9759-0

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