Intersectionality in Heart Failure Self-care

Allana, Saleema; Thompson, David R.; Ski, Chantal F.; Clark, Alexander M.

doi:10.1097/jcn.0000000000000661

Cited by 4 publications

(13 citation statements)

References 19 publications

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“…This more complex evaluation is congruent with trial methodology but can better identify the optimal size, scope, and delivery method of CR for different HF population groups, such as patients with more symptomatic HF (New York Heart Association class III) or patients with multiple intersecting sociodemographic factors, such as black women. 50 In addition to identifying benefits across different patient groups, research should also extend from merely measuring service outcomes to understanding these outcomes: that is, the mechanisms of intervention effects and how these vary by population and context. 45,51 This could provide valuable insights into how CR works (or doesn't), and enable services to be better optimised over time for different patient groups.…”

Section: Why Aren't More People With Hf Offered Cardiac Rehabilitation?mentioning

confidence: 99%

Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation?

et al. 2022

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Many people with heart failure do not receive cardiac rehabilitation despite a strong evidence base attesting to its effectiveness, and national and international guideline recommendations. A more holistic approach to heart failure rehabilitation is proposed as an alternative to the predominant focus on exercise, emphasising the important role of education and psychosocial support, and acknowledging that this depends on patient need, choice and preference. An individualised, needs-led approach, exploiting the latest digital technologies when appropriate, may help fill existing gaps, improve access, uptake and completion, and ensure optimal health and wellbeing for people with heart failure and their families. Exercise, education, lifestyle change and psychosocial support should, as core elements, unless contraindicated due to medical reasons, be offered routinely to people with heart failure, but tailored to individual circumstances, such as with regard to age and frailty, and possibly for recipients of cardiac implantable electronic devices or left ventricular assist devices.

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Section: Why Aren't More People With Hf Offered Cardiac Rehabilitation?mentioning

confidence: 99%

Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation?

et al. 2022

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“…There are compelling empirical and ethical justifications for intersectional approaches to heart disease (11,14). Firstly, even in the absence of intersectional approaches, it is well-established that personal, social and demographic factors interact and compound to generate stepwise increases in levels of adversity in heart health outcomes over the life course (11,16).…”

Section: The Growth Of Intersectional Approachesmentioning

confidence: 99%

“…Although intersectionality was first described well over a decade ago (17,18), and it has implications for health and gender, research methodology and populations (13,(40)(41)(42), scant acknowledgement of intersectionality has appeared in the heart disease literature, despite exhortations to use intersectional approaches, for example, in heart failure self-care (14). The literature does refer to the term 'intersection', for example, heart failure at the intersection of heart failure and palliative care (38).…”

Section: Current Evidence On Intersectionality In Heart Diseasementioning

confidence: 99%

“…Intersectional approaches are credible and increasingly common across political and social movements and disciplines (3)(4)(5)(6), including in health (7)(8)(9)(10) and its research methods (11). As we will show in this review, although intersectionality can inform clinical practice (12) and research (13), it has yet to become prominent or used around either heart failure (14) or heart disease (11). This paper is a primer to what intersectionality is, why it is important, and the implications for clinical practice and research into heart failure.…”

Section: Introductionmentioning

confidence: 95%

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Intersectionality and heart failure: what clinicians and researchers should know and do

Allana

Ski

Thompson

et al. 2021

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of review To review the application of intersectionality to heart failure. Intersectionality refers to the complex ways in which disenfranchisement and privilege intersect to reproduce and influence health and social outcomes. Recent findings Intersectionality challenges approaches that focus on a single or small number of socio-demographic characteristics, such as sex or age. Instead, approaches should take account of the nature and effects of a full range of socio-demographic factors linked to privilege, including: race and ethnicity, social class, income, age, gender identity, disability, geography, and immigration status. Although credible and well established across many fields – there is limited recognition of the effects of intersectionality in research into heart disease, including heart failure. This deficiency is important because heart failure remains a common and burdensome syndrome that requires complex pharmacological and nonpharmacological care and collaboration between health professionals, patients and caregivers during and at the end-of-life. Summary Approaches to heart failure clinical care should recognize more fully the nature and impact of patients’ intersectionality- and how multiple factors interact and compound to influence patients and their caregivers’ behaviours and health outcomes. Future research should explicate the ways in which multiple factors interact to influence health outcomes.

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“…There is also a gendering issue in that for men, a disproportionate amount of that caring burden is assumed by women, whereas older women, not infrequently affected by HF, may be bereft of spousal support. Clearly such risk elements are multifactorial, inter-related, and cumulative, and an intersectional approach has recently been proposed as appropriate to the investigation of HF patient-carer dyads [95]. Sociodemographic subsets such as single person households, minority language groups, and those living in rural areas may be particularly exposed.…”

Section: Social Carementioning

confidence: 99%

Palliative Care in Acute Heart Failure

Beattie

Higginson

McDonagh

2020

Curr Heart Fail Rep

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Purpose of Review Palliative care is increasingly acknowledged as beneficial in supporting patients and families affected by heart failure, but policy documents have generally focused on the chronic form of this disease. We examined palliative care provision for those with acute heart failure, based on the recently updated National Consensus Project Clinical Practice Guidelines for Quality Palliative Care. Recent Findings The commonest reason for hospitalization in those > 65 years, acute heart failure admissions delineate crisis points on the unpredictable disease trajectory. Palliative care is underutilized, often perceived as limited to end-of-life care rather than determined by regular systematic needs assessment. No dominant paradigm of palliative care provision has emerged from the nascent evidence base related to this clinical cohort, underscoring the need for further research. Summary Embedding palliative support as mainstream to heart failure care from the point of diagnosis may better ensure treatment strategies for those admitted with acute heart failure remain consistent with patients’ preferences and values.

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Intersectionality in Heart Failure Self-care

Cited by 4 publications

References 19 publications

Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation?

Why Do so Few People with Heart Failure Receive Cardiac Rehabilitation?

Intersectionality and heart failure: what clinicians and researchers should know and do

Palliative Care in Acute Heart Failure

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