Doctoral dissertation

Sonja Tuomisto: Family involvement in self-managed rehabilitation as perceived by persons diagnosed with coronary artery disease

Sonja Tuomisto
The onset of coronary artery disease has a major effect on the lives of the affected person and their family members. With shorter hospital stays, the importance of selfmanaged rehabilitation at home is emphasized, and the patient needs a wide range of support. The purpose of Master of Health Sciences Sonja Tuomisto's cross-sectional dissertation study was to produce a statistical model of family involvement in the rehabilitation process of persons diagnosed with coronary artery disease (CAD) and the factors associated with it.

Data were collected between 2013-2015 with convenience sampling from persons with CAD who were being discharged from the hospital or who were already discharged. The sample size was based on a power analysis, and informed consent was obtained from 218 persons with CAD from one university hospital. A postal questionnaire was used to collect the data at least six weeks after hospital discharge. The questionnaire was answered by 172 people.

The Family Involvement in Rehabilitation (FIRE) instrument was developed and tested to conduct this study, and it measures family involvement in the rehabilitation process of persons with CAD from the perspective of family promoting rehabilitation and issues encumbering rehabilitation in family. Additionally, the Family Functioning and Family Health scales from the Family Functioning, Health and Social Support (FAFHES) questionnaire were used. Data were analyzed with statistical methods by using descriptive statistics, parametric and non-parametric tests, and multivariate methods.

Respondents perceived that family contribute significantly to their rehabilitation, but they also reported experiencing things that make rehabilitation more difficult in their family life. By accounting for the factors influencing family involvement, health care professionals can contribute to the self-managed rehabilitation of a person with coronary artery disease.

Well-functioning and healthy family relationships contribute to the family members’ ability to participate in the rehabilitation of persons with CAD, and they reduce the likelihood of family problems. Therefore, it would be very important to discuss family relationships before a person with coronary artery disease is discharged from the hospital and also during the whole rehabilitation process.

Men with coronary heart disease, as well as those with adult children, need support especially for difficulties dealing with emotions, family interaction, and sharing responsibilities in everyday life in order to minimize family problems. As an important factor, the susceptibility of cardiac symptoms and the treatment procedures performed must also be considered.

The study found that people who underwent bypass surgery experience more encumbering issues in their family lives, and they need guidance and support to facilitate recovery. An open discussion of the family situation between healthcare personnel and a person with coronary artery disease and his or her family members can significantly facilitate the patient’s self-managed rehabilitation.

The information produced by the study can be utilized in the treatment of patients with coronary artery disease and in the guidance and support of their family members and on the education of health care staff.

The doctoral dissertation of Master of Health Sciences Sonja Tuomisto in the field of nursing science titled Sepelvaltimotautia sairastavien henkilöiden kokemukset perheen osallisuudesta kotona tapahtuvaan kuntoutumiseen will be publicly examined at the Faculty of Social Sciences of Tampere University at 12 o'clock on Wednesday 16 June, 2021. The venue is Arvo building auditorium  F114, address: Arvo Ylpön katu 34, Kauppi campus. Professor Katri Vehviläinen-Julkunen from the University of Eastern Finland will be the opponent while docent Meeri Koivula will act as the custos.

The event can be followed via remote connection

The dissertation is available online at


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