Understanding Palliative Care on the Heart Failure Care Team: An Innovative Research Methodology

Lingard, Lorelei; McDougall, Allan; Schulz, Valerie; Shadd, Joshua; Marshall, Denise; Strachan, Patricia H.; Arnold, J. Malcolm O.; Kimel, Gil

doi:10.1016/j.jpainsymman.2012.04.006

Cited by 30 publications

(26 citation statements)

References 75 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We used an innovative methodological team sampling unit (TSU) approach that explores how health‐care teams are defined and experienced by individuals with HF . Five Canadian cities in three provinces with differing health‐care organization for primary and secondary care and for the care of heart failure patients were identified as recruitment sites (Table ).…”

Section: Methodsmentioning

confidence: 99%

‘Who is on your health‐care team?’ Asking individuals with heart failure about care team membership and roles

LaDonna

Bates

McDougall

et al. 2016

Health Expectations

Self Cite

View full text Add to dashboard Cite

BackgroundComplex, chronically ill patients require interprofessional teams to address their multiple health needs; heart failure (HF) is an iconic example of this growing problem. While patients are the common denominator in interprofessional care teams, patients have not explicitly informed our understanding of team composition and function. Their perspectives are crucial for improving quality, patient‐centred care.ObjectivesTo explore how individuals with HF conceptualize their care team, and perceive team members' roles.Setting and ParticipantsIndividuals with advanced HF were recruited from five cities in three Canadian provinces.DesignIndividuals were asked to identify their HF care team during semi‐structured interviews. Team members' titles and roles, quotes pertaining to team composition and function, and frailty criteria were extracted and analysed using descriptive statistics and content analysis.ResultsA total of 62 individuals with HF identified 2–19 team members. Caregivers, nurses, family physicians and cardiologists were frequently identified; teams also included dentists, foot care specialists, drivers, housekeepers and spiritual advisors. Most individuals met frailty criteria and described participating in self‐management.DiscussionIndividuals with HF perceived being active participants, not passive recipients, of care. They identified teams that were larger and more diverse than traditional biomedical conceptualizations. However, the nature and importance of team members' roles varied according to needs, relationships and context. Patients' degree of agency was negotiated within this context, causing multiple, sometimes conflicting, responses.ConclusionIgnoring the patient's role on the care team may contribute to fragmented care. However, understanding the team through the patient's lens – and collaborating meaningfully among identified team members – may improve health‐care delivery.

show abstract

Section: Methodsmentioning

confidence: 99%

‘Who is on your health‐care team?’ Asking individuals with heart failure about care team membership and roles

LaDonna

Bates

McDougall

et al. 2016

Health Expectations

Self Cite

View full text Add to dashboard Cite

show abstract

“…, Lingard et al . ). Initially, study investigators used constructivist grounded theory (Charmaz ) with the goal of informing theoretical frameworks for educational training and policy development involving palliative care for patients with advanced HF (Carstairs , Chattoo and Atkin ).…”

Section: Methodsmentioning

confidence: 97%

“…This project occurred within a multi-site qualitative study of health care within complex, distributed Canadian HF care teams (LaDonna et al 2017, Lingard et al 2013. Initially, study investigators used constructivist grounded theory (Charmaz 2014) with the goal of informing theoretical frameworks for educational training and policy development involving palliative care for patients with advanced HF (Carstairs 2010, Chattoo andAtkin 2009).…”

Section: Methodsmentioning

confidence: 99%

Beyond the realist turn: a socio‐material analysis of heart failure self‐care

McDougall

Kinsella

Goldszmidt

et al. 2018

Sociology Health & Illness

Self Cite

View full text Add to dashboard Cite

For patients living with chronic illnesses, self-care has been linked with positive outcomes such as decreased hospitalisation, longer lifespan, and improved quality of life. However, despite calls for more and better self-care interventions, behaviour change trials have repeatedly fallen short on demonstrating effectiveness. The literature on heart failure (HF) stands as a case in point, and a growing body of HF studies advocate realist approaches to self-care research and policymaking. We label this trend the 'realist turn' in HF self-care. Realist evaluation and realist interventions emphasise that the relationship between selfcare interventions and positive health outcomes is not fixed, but contingent on social context. This paper argues socio-materiality offers a productive framework to expand on the idea of social context in realist accounts of HF self-care. This study draws on 10 interviews as well as researcher reflections from a larger study exploring health care teams for patients with advanced HF. Leveraging insights from actor-network theory (ANT), this study provides two rich narratives about the contextual factors that influence HF self-care. These descriptions portray not self-care contexts but self-care assemblages, which we discuss in light of socio-materiality.

show abstract

“…More recently, Lingard et al (2013) reported that HF patients had fewer choices regarding end-of-life care compared to cancer patients. In this study 93% of respondents agreed or strongly agreed that a dying person should be allowed to make decisions about their physical care indicating that cardiac nurses have a clear understanding of the importance of keeping the patient at the centre of their care.…”

Section: Attitudes To Caring For Dying Patients and Their Familiesmentioning

confidence: 99%

A palliative care approach in heart failure: knowledge and attitudes of cardiac nurses

Barrett

Connaire

2016

British Journal of Cardiac Nursing

View full text Add to dashboard Cite

Applying the principles and practice of a palliative care approach can enhance quality of life of patients suffering with heart failure yet many nurses misunderstand the role of palliative care.Aim: This study examined the knowledge and attitudes of cardiac nurses of a palliative care approach when caring for heart failure patients.Method: Two validated questionnaires were used to examine the knowledge and attitudes of 102 nurses in three Irish university hospitals.Results: 76 nurses responded (75%) and the study found that there was limited overall knowledge but positive attitudes to palliative care. A positive correlation was identified between higher knowledge scores and positive attitudes, indicating that those with greater knowledge of palliative care demonstrated more favourable attitudes to caring for dying patients. Conclusion:Addressing the palliative care needs of heart failure patients requires education and training and this study identified specific educational needs in pain and symptom control and communication skills.

show abstract

Understanding Palliative Care on the Heart Failure Care Team: An Innovative Research Methodology

Cited by 30 publications

References 75 publications

‘Who is on your health‐care team?’ Asking individuals with heart failure about care team membership and roles

‘Who is on your health‐care team?’ Asking individuals with heart failure about care team membership and roles

Beyond the realist turn: a socio‐material analysis of heart failure self‐care

A palliative care approach in heart failure: knowledge and attitudes of cardiac nurses

Contact Info

Product

Resources

About