A qualitative meta-synthesis of patients with heart failure perceived needs

Abstract

Supportive care may have significant input into the treatment of patients with heart failure (HF). Support, understanding and being treated as a whole and unique person are vital for patients with HF. In order to develop a person-centred program, it is important to know patients' needs from their perspectives. The aim of the current review and meta-synthesis was to explore the needs of patients with HF from their perspective. A qualitative review was conducted using the keywords: (''needs" OR "need") AND (''heart failure") AND (''qualitative") in four databases. Pre-defined inclusion and exclusion criteria were set. The 'Consolidated criteria for reporting qualitative studies' item checklist was used to assess the research methodologies of the included studies. A ''thematic synthesis'' methodological approach was used: (1) Line by line coding of the findings from primary studies. (2) The resulting codes were organized into related areas thus building descriptive themes. (3) Analytical themes were developed. Eleven articles were included in the present review. The results from the meta-synthesis extracted five different categories covering patents' needs: Self-management, palliative care, supportive care, social support and continuing person-centred care. The need for continuing empowerment and support to meet those needs was also identified, revealing the core theme: 'Wind beneath my wings' . The meta-synthesis quotations highlighted the necessity for dynamic and interactive continuing person-centred care focusing on the ongoing patients' needs through the HF trajectory. Giving more emphasis to the human dimension and holistic approach of patients with HF, along with cardiology medicine development might be a key factor in improving clinical outcomes and health related quality of life.

Healthcare needs in elderly patients with chronic heart failure in view of a personalized blended collaborative care intervention: a cross sectional study

“…The remaining participants suggested that the treatment should consider aspects of patients' personal life, such as quality of life, and should be modified, especially with regard to medical therapies. These results are in line with the literature, which also suggests that individual tailoring of treatment is beneficial regarding treatment burden management, ameliorates care adaptation to everyday life and engages patients in improving their health ( 20 – 22 ). In addition, some HF patients not only expressed the need for a change of medical treatment, likely associated with polypharmacy and treatment burden ( 38 , 39 ), but also the need of improving their quality of life.…”

“…Concerning monitoring, more than three quarters of the participants wished that the CM would check symptoms (such as shortness of breath, weight gain, blood pressure, glucose, and cholesterol) as specified in the cards, whereas the rest of the participants preferred assistance with medication prescription, following treatment recommendations and additional medical information. The results are supported by previous studies ( 20 , 21 ) and highlight the importance of addressing and monitoring needs among elderly HF patients for clinical stability ( 34 ).…”

“…To provide such individualized support, several authors highlighted the importance of taking into consideration HF patients' needs and preferences from their and/or their carers' perspectives ( 20 – 22 ). By tailoring healthcare to patients' specific needs, BCC provides personalized support, better coordination and has potential to improve overall well-being and quality of life ( 11 – 13 ).…”

“…According to review of the literature, there is a lack of studies investigating chronically ill patients' needs and preferences in view of BCC, which is also the case for elderly HF patients. The existing literature regarding needs of elderly patients with HF is based both on qualitative investigations, which provide an explorative view on them, and quantitative studies based on validated questionnaires ( 20 , 21 ). Therefore, investigating elderly HF patients’ perspective on their healthcare needs is crucial for delivering personalized care they require.…”

“…Additionally, Griber et al ( 24 ) outlined that the use of colored cards in educational environment may support and strengthen memorization and information processing among elderly. According to the literature, the most frequent healthcare needs of geriatric HF patients with comorbidities mainly concern communication, information, social support, self-management and individualized care ( 20 – 22 ), which are reported to change along with disease progression.…”