Background
Patient education is central to the management of individuals with heart failure;
therefore, it is important to know what these patients understand and experience both
clinically and personally.
Objectives
This study qualitatively explored patients' knowledge regarding a heart failure diagnosis,
their understanding of their cardiac care providers' treatment recommendations, and
their views concerning the impact of heart failure on their daily lives and prognosis.
Methods
A qualitative study was conducted whereby data were collected through 25 telephone
interviews with adults being followed for heart failure at a Veterans Affairs medical
center. Subjects were interviewed using semistructured open-ended questions. Audiotaped
responses were analyzed using grounded theory methods.
Results
The majority of participants were elderly, male, and white, and had New York Heart
Association class II disease. Participants without angina typically experienced a
lengthy and difficult diagnostic delay, with symptoms misattributed to comorbid diseases.
Most understood the importance of self-monitoring and adhering to physician recommendations,
and their discussions of life-changing effects typically focused on loss of physical
functioning and decreased quality of life. Although participants wanted to know their
prognosis, most had not received information about it or about advance care planning.
Conclusion
Patients require opportunities for enhanced communication with physicians and health
care team members during the challenging diagnostic period and subsequently need more
information about their medical condition and prognosis.
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Article info
Footnotes
Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
Financial Support: This work was supported in part by the following awards to Dr. Rodriguez: a Merit Review Entry Program Award from the Veterans Affairs (VA) Health Services Research and Development Office (MRP 04-410), a Minority Supplement Award from the National Cancer Institute (3R01 CA100387-03S1), and a grant from the Pilot Project Program of the Center for Health Equity Research and Promotion (LIP 981) and VA Stars and Stripes Healthcare Network 4 (VISN4).
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© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
