Introduction Heart failure is a widespread chronic cardiac illness with varying etiologies. If the HF patients manage themselves at home by following the appropriate advice by healthcare professionals, they tend to have better quality of life and less readmissions. This study was aimed to identify and explore practices of self-management by heart failure patients, home management of heart failure by their family caregivers and hospital management by healthcare providers. Methods A qualitative study was conducted in a tertiary care center in Northern India on participants (patients, their family caregivers, doctors and nurses) who were recruited purposively and interviewed individually by principle investigator using semi-structured questionnaires. Interviews were audio recorded and transcribed after taking informed consent. Iterative process including coding, reviewing and analyzing was done by four researchers and themes were finalized. Results Total 41 participants (15 patients, 12 family caregivers, 4 doctors and 10 nurses) completed the interviews. It was observed that patients and family caregivers were not able to manage heart failure efficiently. Nurses and doctors reported many barriers to provide specialized care to these patients. Discussion There were definite barriers and challenges in the management of heart failure symptoms by the stakeholders. For the patients and family members who suffer this debilitating illness, managing heroically is a challenge. It is important to develop self-care management protocol for the heart failure patients. Healthcare professionals must overcome the barriers to train patients and family caregivers. Multidisciplinary integration can fulfill the gap in providing care to such patients.
Objective: To assess the survival rate, readmission rate, its causes, and outcomes among the preterm neonates that were discharged from the neonatal units of a tertiary care center of northern India. Methods: A retrospective study was conducted in neonatal units of a tertiary care center in northern India. Preterm neonates (<=35 weeks) were admitted in these neonatal units, and their parents were included as participants by total enumeration sampling between July–December 2018. The data was collected from the admission records for the last 6 months from neonatal intensive care unit and from the parents whose babies were discharged. The parents were telephonically interviewed regarding readmissions and mortality. The data relating to the sociodemographic profile of parents, clinical profile of preterm neonates, readmission profile of discharged preterm neonates, and risk predictors for readmission of preterm neonates was collected. Results: A total of 249 preterm neonates were admitted in 6 months. It was found that the survival rate was 197 (79.1%); the readmission rate was 23 (16.4%). Out of total readmitted, majority 22 (95.7) had low maternal education as risk predictor of readmissions, followed by habitats of rural area. Conclusion: Preterm neonates are at more risk for getting multiple readmissions as compared to other neonates. Thus, there is a need to find out the strategies to overcome the burden of readmissions.
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