Hospital High Vigilance In Informal Carers Taking Care Of Hospitalised Patients With Heart Failure
: A Constructivist Grounded Theory

  • Paul Calleja

Student thesis: Doctoral Thesis


This study is a constructivist grounded theory study about informal care by caregivers during admission and hospitalisation of patients suffering from chronic heart failure (CHF) in Malta. The informal carers pass through demanding and stressful moments when their relatives are admitted and hospitalised. Understanding this social process could help provide the informal carers with tools in coping with this stressful situation.

This study aimed to develop a substantive theory of informal care by caregivers during admission and hospitalisation of patients with chronic heart failure. The new substantive theory was generated from qualitative, semi-structured, in-depth dyadic face-to-face interviews (informal carers and patients). The researcher interviewed 21 participants (13 informal carers and 8 patients). Data analysis was concurrent with data collection, using constant comparison methods and grounded theory coding. Sampling began as purposive, with informal carers taking care of patients suffering chronic heart failure in Malta, and progressed to theoretical sampling. Data analysis continued until theoretical sufficiency had been reached.

Findings suggest that the informal carers continue to care for possible dangers and difficulties that could happen to their relatives during admission and hospitalisation. The only way the informal carers could still care for their relatives during admission and hospitalisation was to be vigilant. The core category of Hospital High Vigilance based on a symbiotic relationship between the informal carers and patients was co-constructed, explaining the social process of informal care during admission and hospitalisation of a patient suffering from CHF in Malta.

This new theory offers new insight into how informal carers react and cope during a stressful events like admission and hospitalisation of their relatives. Subsequently, the Hospital High Vigilance theory highlights the informal carers’ vulnerability and uncertainty. It provides valuable insight into how the healthcare professional could interact, collaborate with, and involve the informal carers in the care of their relatives during admission and hospitalisation.
Date of AwardOct 2022
Original languageEnglish
Awarding Institution
  • University of Brighton
SupervisorJulie Scholes (Supervisor), Nina Stewart (Supervisor), Josef Trapani (Supervisor) & Catherine Theodosius (Supervisor)


  • Vigilance
  • Admission
  • Hospitalisation
  • Informal carers
  • Heart failure
  • Constructivist Grounded Theory

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