Continuities and Temporal Disruptions: Temporal Aspects of the Good Life in Patients with Heart Disease from the Perspectives of Generativity and Gender

The aim of the second funding period is to deepen the understanding of the good life over time in patients with heart disease by incorporating the aspects of generativity and gender. The psychocardiological subproject (SP-C) builds both on the results of the first funding period and on prior work on the phenomenology of embodiment, temporality, self-determination, and quality of life in health and illness. During the first funding period, it was shown that individuals with severe heart disease experience the illness as a profoundly unsettling rupture in their lives and depend on medical as well as emotional support in coping with it. Coming to terms with severe heart disease confronts patients with death and mortality and gives rise to a need for self-care and sustaining relationships.

In the further course of dealing with heart disease, aspects of post-traumatic growth are also reported, that is, a changed attitude toward life and a reorientation of one’s way of living. An increased awareness of one’s own finitude and gratitude for being able to continue living thanks to experienced medical and emotional care lead, in the post-acute phase, to the desire to give something back. As close relationships gain greater subjective significance, a need for reciprocation and transmission emerges, in which aspects of generativity already become apparent. These forms of generativity—in a general sense (cultural, institutional), as midlife generativity (reproduction and parenthood), and as late-life generativity (legacy in advanced age), as well as their impediments and possible failure—are to be investigated in patients with heart disease.

The planned qualitative interviews and focus groups aim to further deepen the topic, particularly from a gender perspective, as has long been called for in cardiology: namely, the consideration of sociocultural and biological sex in questions concerning the good life and generativity in the context of heart disease. A paradigmatic example is the situation of a female patient with a congenital heart defect whose desire to have children (or decision for or against pregnancy) must be made against the background of a potential life-threatening risk to the mother and/or the child.

Finally, we aim to make the qualitative empirical findings from the first and second funding periods applicable to clinical practice. To this end, the results from studies with heart patients on conceptions of the good life and experiences of time—further elaborated by incorporating aspects of generativity and gender effects—will be used to develop a computer-adaptive testing (CAT) instrument for younger and middle-aged adults as well as for older age (>65 years). Owing to the inclusion of these aspects, we explicitly conceptualize the construct of the “good life” with heart disease more broadly than the construct of health-related quality of life (HRQoL) commonly used in medical outcomes research.

 

The subproject is based at the sites of Göttingen and Berlin, enabling comprehensive expertise for this complex research question: