Background More than half of all patients with heart failure (HF) do not take medications as prescribed, resulting in negative health outcomes. Research has shown that medication adherence may be intentional rather than the ability to follow prescribed regimens, yet very little is known about medication-taking decisions in older patients with HF. Objective The purpose of this qualitative study was to gain insight into the decision-making processes and experiences of older patients with HF by exploring the different aspects in choosing to take or not take medications as prescribed in the community setting. Methods Using a narrative inquiry approach, the personal narratives of 11 adults 65 years or older who took at least 2 daily medications for HF were gathered using in-depth, semistructured interviews. The data in this study were organized and analyzed using Riessman's framework for narrative analysis. Results Participants made intentional decisions to take particular medications differently than prescribed. A worrisome symptom prompted a naturalistic decision-making process. When a medication interfered with attaining a personal goal, participants coped by individualizing their medication regimen. Participants did not consider taking a medication differently than prescribed as nonadherence but a necessary aspect of maintaining a personal level of health, which could be seen as self-care. Conclusions The older patient with HF should be carefully assessed for nonadherence. The development of interventions that are patient specific, target medications with the greatest potential for nonadherence, and use easy-to-access resources may promote decisions for medication adherence. More research is needed to develop interventions that promote decisions for medication adherence.
Despite the benefits of diuretics for treating the symptoms of heart failure (HF), patients may report side effects and intentionally not adhere to diuretic regimens. Positive internal motivators, such as positive emotions, may benefit individuals in their adaptation to medication-related stress. However, there has been limited study of these potential motivators in those with HF. Using a descriptive qualitative approach, 82 adults taking diuretics for HF were interviewed. This study applied stress and coping theory to understand the diuretic-taking experiences of patients with HF. Data analysis revealed three themes: (a) diuretics are bothersome, (b) staying positive in the mid of hardship, and (c) adapting to endure. Findings suggest that adherent participants stayed positive amid the perceived hardship, maintaining resilient and grateful attitudes. Adherent participants adapted to bothersome diuretic effects and utilized creative strategies. More research is needed to understand the relationships between resilience, adaptive coping, and diuretic adherence.
The objective of this article is to provide clinicians, from multiple disciplines, important clinical information to consider when providing health education and emotional support to persons with chronic lower respiratory disease (CLRD) and their informal caregivers via telehealth. The information contained in this article is based on a literature review, a needs and preferences survey of this population (n ϭ 49 persons with CLRD; n ϭ 49 informal caregivers) that was part of a larger study (Enhancing Rural Interventions for Caregiver Health [En-Rich]), and our clinical experience. The En-Rich needs and preferences survey was conducted to help shape telehealth services for this population particularly those residing in rural/geographically isolated areas as well as those who are not physically well enough to attend clinic-based appointments. As a result of the novel coronavirus (COVID-19) pandemic, the use of telehealth services for clinical care has dramatically risen for a variety of reasons. We surmise that persons with CLRD and their informal caregivers are particularly open to telehealth services at this time, given the risk of exposure to the virus upon leaving their homes.As such, we provide information about the physical and psychosocial aspects of living with CLRD from the perspective of patients and informal caregivers along with 7 practical recommendations for providing telehealth services to this population. Our aim is to better equip telehealth clinicians who are working with this special population through our interdisciplinary lens (gerontology, nursing, health psychology, and social work). Clinical Impact StatementA formal literature review, needs and preferences survey, and our interdisciplinary clinical expertise shaped our recommendations for the provision of telehealth education and emotional support for persons with chronic lower respiratory disease (CLRD) and their informal caregivers. The recommendations were written in the context of COVID-19 pandemic which has increased the need for telehealth services for this clinical population as well as empirically supported education for the clinicians who serve them.
Personal narrative is at the heart of how human beings share information, represent identity, and convey ideas. Narrative research is a form of qualitative analysis that assists researchers in gaining insight into the lived experiences of the persons they are studying within their unique life circumstances and contexts. Although many narrative investigations report themes from study data, there is no single, well-defined approach to data analysis in narrative research. In this article, we provide a method for analyzing the data beyond the spoken words by applying Riessman’s thematic, structural, and performance analysis. We describe how applying multiple methods of systematic evaluation to narrative data leads to a deeper and more valid insight into the told stories. The data analysis process outlined in this article contributes to the academic discourse and knowledge supporting the use of multiple methods of systematic evaluation to uncover deeper meaning and thus leading to greater validity of the findings from narrative data.
Background: Personal and psychological factors, such as depression, have a considerable influence on nonadherence to medications and self-care in those with heart failure. More evidence is needed about positive personal factors that motivate adherence to medications and self-care in those with heart failure. Objective: The purpose of this study was to investigate whether there was a relationship between the personal resources of resilience, hope, health literacy, social support, and self-care activation and adherence to HF self-care and medications and whether race impacts adherence. Methods: This study used a cross-sectional, correlational design. Stepwise regression was used to test whether resilience, hope, health literacy, self-care activation, and race significantly predicted medication adherence and self-care. A diverse sample was recruited for this study. Results: Of the 174 participants, 51% were female, 51.7% were White, and the mean age was 62 years. After adjustment for differences in age and depressive symptoms, a predictive relationship remained between resilience, health literacy, and medication adherence. Hope, activation, and race were not selected in the final regression model. A high level of perceived social support was the only predictor of better HF self-care. Conclusion: Persons with heart failure may have better medication adherence and overall self-care if sufficiently resilient, health literate, and supported regardless of their degree of hope or activation. Race and age may be important factors to consider. More research is needed to understand the connection between resilience and medication adherence.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.