Areas for quality improvements in heart failure care: quality of care from the patient's perspective

Ängerud, Karin Hellström; Boman, Kurt; Ekman, Inger; Brännström, Margareta

doi:10.1111/scs.12404

Cited by 7 publications

(5 citation statements)

References 52 publications

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“…He suggests the need of new collaboration models that include healthcare professionals, patients and their families to reduce fragmentation and enhance continuity of care. A Swedish study showed that there is a great potential for improvement regarding access to care and treatment over time in patients with HF [26].…”

Section: Introductionmentioning

confidence: 99%

“Being in good hands”: next of kin’s perceptions of continuity of care in patients with heart failure

et al. 2019

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BackgroundHeart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin’s perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF.MethodsThis study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n = 15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants’ perceptions of the phenomenon.ResultsThe analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin’s perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities.ConclusionsNext of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of “being in good hands” sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin.

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Section: Introductionmentioning

confidence: 99%

“Being in good hands”: next of kin’s perceptions of continuity of care in patients with heart failure

et al. 2019

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“…Recent literature indicates rates of cachexia among Brazilians hospitalized with HF of up to 48.1% and 61.8% have malnutrition (Tinoco et al, 2021). From the patients’ perspective, effective treatment for loss of appetite is an area that requires quality improvement in HF care (Ängerud et al, 2017) and in the care delivered to older adults in general who are hospitalized (Brunner et al, 2022). This is the first study that systematically assessed the appetite of patients with HF in Brazil and the second in the world, to the best of our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Relationships between Depressive Symptoms, Appetite, and Quality of Life in Heart Failure

et al. 2022

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This analytical, cross-sectional study aimed to analyze the relationship between depressive symptoms, appetite, and quality of life (QoL) in 86 patients hospitalized with heart failure. Patients were assessed for depressive symptoms, appetite, and QoL using the Beck Depression Inventory-II, the Simplified Nutritional Appetite Questionnaire, and the Minnesota Living with Heart Failure Questionnaire, respectively. Relationships between sociodemographic and clinical variables, depressive symptoms, appetite, and QoL were analyzed using bivariate tests and linear regression models, with p < .05 considered significant. The factors associated with QoL were dependence for four activities of daily living (ADLs) (estimate = 15.4, 95% CI = 0.23 to 30.64, p = .046), minor depressive symptoms (estimate = –20.0, 95% CI = –28.3 to −11.73, p < .001), and appetite (estimate = –11.08, 95% CI = –20.5 to −1.62, p = .022). These results can support multi-professional assessment and development of interventions to promote better QoL, including addressing impaired appetite and food intake, the presence or increased intensity of depressive symptoms, especially in patients dependent for ADLs.

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“…This study, presents that nurses experience access and flexibility in the care contacts as a basic prerequisite for continuity of care in patients with HF. Other studies in this area have highlighted access to care as an aspect of quality of health care that needs to be improved (Ängerud et al, 2017, 2018; Browne et al, 2014). In this study, the nurses stated that access to multidisciplinary teams and built‐in flexibility in planning visits were both essential to continuity of care for patients with HF.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of continuity of care for patients with heart failure: A thematic analysis

Östman

Bäck‐Pettersson

Sundler

et al. 2020

Journal of Clinical Nursing

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Aims and Objectives This study aimed to describe nurses’ experiences of continuity of care for patients with heart failure. Background Heart failure is a life‐influencing condition that causes varying care needs over time with risks of fragmentation. Nurses play an important role in caring for patients with heart failure. However, nurses’ experiences of continuity of care seem to be less explored in this context. Design A qualitative study with a descriptive design. Methods Four focus groups were chosen to collect the data, and the analysis was made by using a method for thematic analysis. A purposeful sampling of nurses (n = 14) with experiences from hospital‐connected heart failure clinics, primary healthcare centres and municipal home healthcare settings was recruited. The COREQ checklist was used in this study. Results The nurses’ experiences of continuity of care for patients with heart failure were described in four themes: access and flexibility, responsibility and transparency, trustful and caring relationships and communication and collaboration. Conclusions The results indicate that nurses have an excellent position to act as the “hub” in caring for patients with heart failure, but they need to have the possibility of networking and establishing trusting relationships with their colleagues. From the nurses’ point of view, mutual trust between the nurse, the patient and the patient's next of kin is crucial for promoting and maintaining continuity of care in patients with heart failure. Relevance to clinical practice To promote continuity of care for patients with heart failure, nurses expressed the necessity of establishing trusting relationships in a continuity‐promoting organisation with seamless coordination. Nurses can be the “hub” supporting a person‐centred care approach based on the patients’ needs. There seems to be a need for better collaboration with common guidelines across and within primary healthcare centres, hospital‐connected heart failure clinics and municipal home healthcare settings.

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Areas for quality improvements in heart failure care: quality of care from the patient's perspective

Abstract: Important areas for improvement in the quality of care for patients with heart failure in an outpatient setting were identified, such as symptom alleviation, information, participation and access to care.

Cited by 7 publications

References 52 publications

“Being in good hands”: next of kin’s perceptions of continuity of care in patients with heart failure

“Being in good hands”: next of kin’s perceptions of continuity of care in patients with heart failure

Relationships between Depressive Symptoms, Appetite, and Quality of Life in Heart Failure

Nurses’ experiences of continuity of care for patients with heart failure: A thematic analysis

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