Living with breathlessness in chronic heart failure: a qualitative study

Walthall, Helen; Jenkinson, Crispin; Boulton, Mary

doi:10.1111/jocn.13615

Cited by 22 publications

(35 citation statements)

References 19 publications

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“…Create mental coping strategies [ 14 , 18 , 20 , 40 , 43 , 45 , 46 , 48 - 51 , 61 , 75 - 80 , 83 - 89 ] included overcoming emotional barriers [ 18 ], drawing upon spiritual beliefs [ 78 ], eventually coming to terms with a new body and a new normal [ 14 , 20 , 87 , 89 ] that enables patients to proactively engage with treatment. Patients also looked for relevant knowledge, either from written literature or by asking other people, in work tasks under learning about the disease [ 16 , 20 , 42 , 48 , 57 , 59 , 60 , 64 , 67 , 73 , 74 , 78 , 80 , 81 , 84 , 90 ]. Intellectual endeavors to understand the implications of symptoms [ 52 ] are also included here.…”

Section: Resultsmentioning

confidence: 99%

“…Category 4 was the only category that explicitly described how patients changed their physical environment and tools. Tasks in this category (eg, use and maintain assistive devices [ 16 , 20 , 42 , 50 , 56 , 58 , 59 , 62 , 67 , 69 , 72 , 74 , 89 , 90 , 95 , 97 , 98 ], do-it-yourself symptom management tools [ 18 , 19 , 47 , 59 , 62 , 66 , 74 , 77 , 95 ], and alter the physical environment [ 46 , 62 , 93 ]) had an immediate physical return in the form of better tools or a more comfortable physical environment, with the tools ranging from day-to-day items (eg, shoe insoles [ 97 ]) to specialized equipment (such as home oxygen tanks [ 59 ]). Patients are very aware of how this category is an investment to improve the quality of life as well as what kind of support (mainly financial) is available from health organizations.…”

Section: Resultsmentioning

confidence: 99%

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Patient Work and Their Contexts: Scoping Review

et al. 2020

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Background Having patients self-manage their health conditions is a widely promoted concept, but many patients struggle to practice it effectively. Moreover, few studies have analyzed the nature of work required from patients and how such work fits into the context of their daily life. Objective This study aimed to review the characteristics of patient work in adult patients. Patient work refers to tasks that health conditions impose on patients (eg, taking medications) within a system of contextual factors. Methods A systematic scoping review was conducted using narrative synthesis. Data were extracted from PubMed, Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, including studies from August 2013 to August 2018. The included studies focused on adult patients and assessed one or more of the following: (1) physical health–related tasks, (2) cognitive health–related tasks, or (3) contextual factors affecting these tasks. Tasks were categorized according to the themes that emerged: (1) if the task is always visible to others or can be cognitive, (2) if the task must be conducted collaboratively or can be conducted alone, and (3) if the task was done with the purpose of creating resources. Contextual factors were grouped according to the level at which they exert influence (micro, meso, or macro) and where they fit in the patient work system (the macroergonomic layer of physical, social, and organizational factors; the mesoergonomic layer of household and community; and the microergonomic triad of person-task-tools). Results In total, 67 publications were included, with 58 original research articles and 9 review articles. A variety of patient work tasks were observed, ranging from physical and tangible tasks (such as taking medications and visiting health care professionals) to psychological and social tasks (such as creating coping strategies). Patient work was affected by a range of contextual factors on the micro, meso, or macro levels. Our results indicate that most patient work was done alone, in private, and often imposing cognitive burden with low amounts of support. Conclusions This review sought to provide insight into the work burden of health management from a patient perspective and how patient context influences such work. For many patients, health-related work is ever present, invisible, and overwhelming. When researchers and clinicians design and implement patient-facing interventions, it is important to understand how the extra work impacts one’s internal state and coping strategy, how such work fits into daily routines, and if these changes could be maintained in the long term.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Patient Work and Their Contexts: Scoping Review

et al. 2020

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“…Debilitating symptoms of heart failure include breathlessness, fluid retention, and chronic fatigue. [7,9,10] Heart failure hospitalizations are at the highest frequency in the United States among other morbidities accounting for an estimated $30.7 billion in annual health care costs. [1,3,11] Heart failure is the most common cause of thirty day hospital readmission.…”

Section: Introductionmentioning

confidence: 99%

Improving heart failure transitional care after hospital discharge: A quality improvement project

Akomah

Richards-McDonald

Baptiste

2020

JNEP

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Background and objective: The burden of heart failure is growing, affecting more than 6 million Americans and an estimated of 26 million worldwide. Heart failure is the most common cause of hospital readmission in the United States and is identified as a marker of poor health outcomes. Thirty day readmission contribute to more than $30 billion dollars in health care expenditures, underscoring a need for the development and implementation of programs that reduce readmission and improve outcomes for individuals with heart failure. The purpose of this quality improvement project was to implement a heart failure education program to increase attendance to a transitional care clinic and reduce 30-day readmissions.Methods: We included 22 individuals who received heart failure education, focused on symptom management and transitional care. Descriptive and statistical analyses were performed to examine attendance to the transitional care clinic and 30-day readmission.Results: There was a statistical significance between individuals attending follow-up at the designated transitional care clinic and 30-day hospital readmission (p ≤ .05). Of the (N = 22) participants, 64% were not readmitted into the hospital 30 days after discharge.Conclusions: The findings of this project demonstrate that a nurse-led evidence-based heart failure education program can improve attendance to transitional care programs and reduce 30-day readmissions. A well-designed plan for transitional care remains a critical component of patient care necessary to address complications and optimize continuity of care after discharge.

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“…This classification is traditionally used as the basis for medical treatment [38]. Heart failure has serious consequences on the patient's social, physical and mental wellbeing [39][40][41]. Heart failure symptoms cause burdensome physical limitations that affect the patient's ability to perform basic home routines such as cleaning and washing dishes.…”

Section: Heart Failure Symptoms and Comorbiditymentioning

confidence: 99%

“…Heart failure symptoms cause burdensome physical limitations that affect the patient's ability to perform basic home routines such as cleaning and washing dishes. The symptom burden causes emotional stress and frustrations over the life situation, and many patients try to find coping strategies to live as normal a life as possible [41]. The progression of HF is unpredictable.…”

Section: Heart Failure Symptoms and Comorbiditymentioning

confidence: 99%

Appetite in patients with heart failure: Assessment, prevalence and related factors

Andreae¹

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Living with breathlessness in chronic heart failure: a qualitative study

Cited by 22 publications

References 19 publications

Patient Work and Their Contexts: Scoping Review

Patient Work and Their Contexts: Scoping Review

Improving heart failure transitional care after hospital discharge: A quality improvement project

Appetite in patients with heart failure: Assessment, prevalence and related factors

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