Research and Theory for Nursing Practice: An International Journal, Vol. 25, No. 1, 2011

A Process of Decision Making by Caregivers of Family Members With Heart Failure
Julie Sanford, DNS, RN
University of South Alabama, Mobile

Judith Townsend-Rocchicciolli, PhD, RN
James Madison University, Virginia

Annie Horigan, MSN, RN
Duke University, North Carolina

Pat Hall, PhD, CRNP
Diagnostic Medical Clinic, Mobile, Alabama

Heart failure (HF) is a major cardiovascular problem and the number of people living with HF continues to climb. Throughout the illness continuum, patients and their family caregivers are involved in decision making. As the illness worsens and patients can no longer make decisions, decision making becomes the responsibility of their caregivers who may have little preparation for the role. The purpose of this grounded theory study was to examine how caregivers of family members with HF make decisions. A nonlinear decision-making process consisting of several actions was identified, which included actualizing; seeking input, information, or support; reflecting; choosing; evaluating; and validating the decision.

Keywords: decision making; heart failure; caregiving; grounded theory eart failure (HF), a complex cardiovascular syndrome, is increasing in incidence throughout the world. In 2003, the World Health Organization (WHO) noted that cardiovascular disease accounted for more than 16.7 million deaths (29.2%) of all deaths worldwide with 7.2 million of these deaths attributed to ischemic heart disease. According to the American Heart Association (AHA), almost

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© 2011 Springer Publishing Company
DOI: 10.1891/0889-7182.25.1.55

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6 million Americans have HF with more than 670,000 new patients who are 45 years of age or older diagnosed each year (AHA, 2009). In 2003, the Study Group on HF Awareness