Heart failure patients’ attitudes, beliefs, expectations and experiences of self-management strategies: A qualitative synthesis

Wingham, Jennifer; Harding, Geoffrey; Britten, Nicky; Dalal, Hasnain M

doi:10.1177/1742395313502993

Cited by 46 publications

(72 citation statements)

References 42 publications

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“…Patients' descriptions reveal that receiving a HF diagnosis entails shaping a new identity (Welstand et al 2009, Wingham et al 2014. This process includes everything that results from the diagnosis, such as perceptions of day-to-day life, coping strategies, and making sense of an unpredictable life.…”

Section: Impact On Everyday Life and Quality Of Lifementioning

confidence: 99%

“…Individualised self-care education was one important part of structured HF home-care, and patients also described that the knowledge they obtained helped them to handle their situation (II). The patients were fairly knowledgeable about HF when they were enrolled in structured home-care (I), but there is a constant need for more knowledge in order to handle upcoming situations related to the HF condition , Wingham et al 2014.…”

Section: Patient Participation In Heart Failure Home-carementioning

confidence: 99%

“…It ends with assimilation to the constraints and restrictions that are associated with daily life in HF. However, most of the patients need to revisit earlier phases due to deterioration of their HF (Wingham et al 2014). These processes influence the patient's self-care (Welstand et al 2009, Wingham et al 2014.…”

Section: Impact On Everyday Life and Quality Of Lifementioning

confidence: 99%

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Participation in heart failure home-care : Patients’ and partners’ perspectives

Näsström¹

2015

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Introduction: Patient participation is important for improving outcomes and respecting selfdetermination and legal aspects in care. Heart failure is a chronic condition that puts high demands on self-care and patient participation. Patients often need advanced care due to deterioration of their heart failure symptoms, and one option is to provide care as home-care. There is limited knowledge of how patients with heart failure and their partners view participation in home-care. Aim: The overall aim of this thesis was to describe different perspectives of participation in structured heart failure home-care among patients with heart failure and their partners. Methods: All patients in this thesis received structured heart failure home-care, according to a model aiming to facilitate care, where safety, participation, and gaining knowledge about the illness and treatment, are in focus. Study I had a prospective pre-post longitudinal design including 100 patients with heart failure receiving home-care. Data was collected by selfadministered questionnaires. Study II had a descriptive design. Nineteen patients receiving home-care were interviewed, and data was analysed using qualitative content analysis. Study III had a descriptive and explorative design. Data was collected by video-recorded observations of 19 home visits and analysed by qualitative content analysis. Study IV had a parallel convergent mixed-method design including 15 partners of patients receiving structured home-care. Data was collected by interviews and self-administered questionnaires. Datasets were first analysed separately and then together. Results: Better self-care behaviour was significantly associated with all measured aspects of participation. Participation by received information increased significantly during the 12-month follow-up (I). Patients’ descriptions of participation included communication between patients and health care professionals, access to care, active involvement in care, a trustful relation with health care professionals, and options for decision-making(II). Observed care encounters revealed that participation was made possible by; (i) interaction, including exchange of care-related information, care-related reasoning, and collaboration, (ii) an enabling approach, including the patient expresses own wishes and shows an active interest, and the nurse is committed and invites to a dialogue (III). Partners scored fairly positive for their participation in care and they performed different levels of caregiving tasks. Descriptions of participation included; adapting to the caring needs and illness trajectory, mastering caregiving demands, interacting with care providers, and gaining knowledge to comprehend the health situation. The mixed-method results showed both convergent results and expanded knowledge (IV). Conclusions: Structured heart failure home-care facilitated participation both for patients and their partners. Patient participation with regard to received information improved significantly after receiving home-care. As...

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Section: Impact On Everyday Life and Quality Of Lifementioning

confidence: 99%

Section: Patient Participation In Heart Failure Home-carementioning

confidence: 99%

Section: Impact On Everyday Life and Quality Of Lifementioning

confidence: 99%

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Participation in heart failure home-care : Patients’ and partners’ perspectives

Näsström¹

2015

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“…Wingham et al 33 suggest that self-management "is dependent on a range of factors including social and personal influences in conjunction with healthcare systems and health professionals" (p.150). Indeed, research suggests that the link between patient confidence and selfcare 1,34 may depend on the quality of the patient-health professional relationship.…”

Section: Recommendations To Promote Patient Self-management: a Socialmentioning

confidence: 99%

Patient Self-Management In Chronic Heart Failure — Establishing Concordance Between Guidelines And Practice

Toukhsati¹,

Driscoll²,

Hare³

2015

Cardiac Failure Review

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The gold-standard of patient self-management in chronic heart failure (CHF) can be defined as "daily activities that maintain clinical stability". 1 This requires that patients monitor their symptoms, adhere to their medication, diet and exercise regimens and manage symptoms by recognising changes and responding by either adapting behaviours or by seeking appropriate assistance.2 Patient self-management is linked to reduced mortality risk and fewer hospital admissions; however, there is less certainty with regard to the benefits of some aspects of self-care, such as lifestyle choices and fluid restriction.2 According to the European Society of Cardiology Guidelines for the diagnosis and treatment of acute and chronic heart failure, 3 self-management is integral to achieving best patient outcomes: to reduce mortality and improve quality of life.Self-management in CHF usually involves behavioural adaptation.Patients may need to learn new behaviours, such as learning how to monitor and manage symptoms and complex medical regimens.Patients may also need to abstain (e.g. cease smoking), adapt (e.g. AbstractChronic heart failure (CHF) is a progressive and debilitating disease with a broad symptom profile, intermittently marked by periods of acute decompensation. CHF patients are encouraged to self-manage their illness, such as adhering to medical regimens and monitoring symptoms, to optimise health outcomes and quality of life. In so doing, patients are asked to collaborate with their health service providers with regard to their care. However, patients generally do not self-manage well, even with specialist support. Moreover, selfmanagement interventions are yet to demonstrate morbidity or mortality benefits. Social network approaches to self-management consider the availability and mobilisation of all resources, beyond those of only the patient and healthcare providers. Used in conjunction with e-health platforms, social network approaches may offer a means by which to optimise self-management programmes of the future.

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“…The analysis of the literature [138][139][140][141] shows that it is fundamental to treat patients with CHF from the perspective of a chronic and progressive disease, during which they are called upon to put into action cognitive, emotional and behavioral resources that will allow them to live with the disease, adhere to complex therapeutic regimens and maintain a reasonable level of quality of life. The changes of role in the personal, family, and social/work context involve problematic emotional states; moreover, adherence to prescriptions is often conditioned by the complex pharmacological therapy, by the need to monitor physiological parameters and symptoms, and by food restrictions (salt consumption, intake of liquids, abstention from alcohol).…”

Section: Psychological Interventionsmentioning

confidence: 99%

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

Angelino

Porta

Abatello

et al. 2018

Monaldi Arch Chest Dis

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Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on 'new' conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.

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Heart failure patients’ attitudes, beliefs, expectations and experiences of self-management strategies: A qualitative synthesis

Abstract: This conceptual model suggests that there are a range of interplaying factors that facilitate the process of developing self-management strategies. Interventions should take into account patients' concepts of heart failure and their subsequent reactions.

Cited by 46 publications

References 42 publications

Participation in heart failure home-care : Patients’ and partners’ perspectives

Participation in heart failure home-care : Patients’ and partners’ perspectives

Patient Self-Management In Chronic Heart Failure — Establishing Concordance Between Guidelines And Practice

Best practice in psychological activities in cardiovascular prevention and rehabilitation: Position Paper

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