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Improving support for heart failure patients: a systematic review to understand patients' perspectives on self‐care
Author(s) -
Spaling Melisa A.,
Currie Kay,
Strachan Patricia H.,
Harkness Karen,
Clark Alexander M.
Publication year - 2015
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.12712
Subject(s) - psychological intervention , systematic review , medicine , qualitative research , critical appraisal , health care , nursing , psychology , medline , alternative medicine , social science , pathology , sociology , political science , law , economics , economic growth
Aims This systematic review aimed to generate patient‐focussed recommendations to enhance support of heart failure self‐care by examining patients' experiences, perspectives and self‐care behaviours. Background Despite increased recognition of the importance of heart failure self‐care, patients' knowledge and practices around this self‐care and interventions to improve it are inconsistent. Consequently, current guidelines focus on what the domains of heart failure self‐care are, more so than the ways to improve this care. Design Systematic review and qualitative interpretive synthesis. Data sources A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995–2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals) that contained a qualitative research component and data on adult patients' heart failure self‐care. Review methods This interpretive synthesis used a recognized approach consisting of a multi‐stage analytic process; in addition, the included studies underwent quality appraisal. Results Findings indicate that while patients could often recall health professionals' self‐care advice, they were unable to integrate this knowledge into daily life. Attempts to manage HF were based on how patients ‘felt’ rather than clinical indicators of worsening symptoms. Self‐efficacy and learning from past management experiences facilitated favourable outcomes – these enabled patients and caregivers to adeptly apply self‐care strategies into daily activities. Conclusions Addressing common but basic knowledge misconceptions regarding the domains of HF self‐care is insufficient to increase effective HF self‐care; this should be supplemented with strategies with patients and family members to promote self‐efficacy, learning and adaptation/application of recommendations to daily life.