Nurses' strategies to address self-care aspects related to medication adherence and symptom recognition in heart failure patients: An in-depth look

Abstract

Objective: Despite an increasing body of knowledge on self-care in heart failure patients, there is still a need for effective interventions. The aim is to deepen our understanding of interventions that heart failure nurses use in clinical practices to improve patient adherence to medication and symptom monitoring. Methods:A qualitative study with a directed content analysis was conducted using data from a purposeful selected sample of Dutch speaking heart failure nurses, who completed booklets with two cases on medication adherence and symptom recognition.Results: Nurses regularly (re-)assess patients before they decide on an intervention. They assess basic/factual information, barriers in the patient's behavior and try to find room for improvement in patient's behavior. Interventions that heart failure nurses use to improve adherence to medication and symptom monitoring were grouped in the following themes: increasing knowledge, increasing motivation and providing the patients with practical tools.Nurses also described using technology based tools, increasing social support, alternative communication, partnership approaches and coordination of care to improve adherence to medication and symptom monitoring. Conclusion:Despite the strong focus toward the educational strategies, nurses also reported other strategies to increase patient adherence. Nurses use several strategies to improve patient adherence that are not incorporated in guidelines. These interventions need to be evaluated for further use to improve heart failure management 4

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