Using vignettes to understand heart failure self‐care

J Xu, S Arruda, JJ Gallo, J Wenzel… - Journal of clinical …, 2018 - Wiley Online Library
J Xu, S Arruda, JJ Gallo, J Wenzel, MT Nolan, D Flowers, SL Szanton…
Journal of clinical nursing, 2018Wiley Online Library
Aims and objectives To explore hospitalised heart failure (HF) patients' self‐care decisions.
Background Heart failure self‐care is integral to maintain and manage health, and may
prevent unnecessary HF hospitalisations. Nevertheless, self‐care remains challenging for
patients, and using vignettes offer a new perspective to understand patient HF self‐care
decision‐making. Design This qualitative descriptive analysis was conducted as part of a
mixed methods study. Methods We conducted semi‐structured interviews (N= 20) to elicit …
Aims and objectives
To explore hospitalised heart failure (HF) patients' self‐care decisions.
Background
Heart failure self‐care is integral to maintain and manage health, and may prevent unnecessary HF hospitalisations. Nevertheless, self‐care remains challenging for patients, and using vignettes offer a new perspective to understand patient HF self‐care decision‐making.
Design
This qualitative descriptive analysis was conducted as part of a mixed methods study.
Methods
We conducted semi‐structured interviews (N = 20) to elicit patient decisions about self‐care in responses to three vignettes, which varied in symptom severity. Content analysis was used to extract quotes describing participant responses.
Results
Participants were on average 60 years old, primarily male, African American, unemployed and highly symptomatic (NYHA Class III or IV). Overall, participants were able to identify when symptoms required a decision to seek urgent medical attention, but had difficulty identifying the appropriate decision to make in response to less acute symptoms such as swelling.
Conclusions
Symptoms other than shortness of breath were challenging for patients to interpret and manage appropriately. Understanding how to apply HF knowledge to alleviate symptoms was also difficult.
Relevance to clinical practice
Vignettes may be a helpful tool to prompt patient–healthcare provider communication about self‐care management and prompt discussions about appropriate self‐care decisions in response to varying levels of symptom severity.
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