Living with heart failure: Perspectives of patients from Singapore

Abstract

Introduction: Heart failure is a progressive and often incurable condition associated with a poor quality of life. The aim of this study was to understand the experiences and preferences regarding care, communication and decision-making among patients living with heart failure in Singapore. Methods: Five focus groups were conducted with 27 patients that had heart failure. The focus groups were audio-recorded and transcribed verbatim. Thematic analysis was used for analyzing transcripts. Results: Six themes representing the experiences of patients with heart failure were identified. These were: 1) physical and psychological symptoms; 2) financial concerns; 3) uncertainty and lack of knowledge about disease; 4) difficulties in navigating the healthcare system; 5) end-of-life care concerns; and 6) fear of burdening family. Conclusion: The study highlights that health care services for patients with heart failure need to address the multifaceted impacts of the disease on patient's lives. A focus on the provision of comprehensive health care services at the primary care level, training of health care providers in communication skills, involving patients and their families in decision making, and discussions about end-of-life care preferences and goals of care may help to improve care for patients with heart failure.

Effects of Communication Skills Training on Aggression and Quality of Life of Male Patients with Chronic Mental Illnesses

“…In another study, it was shown that limitations in physical activities, mental disorders such as anxiety, and lack of knowledge about the disease can negatively affect QoL of these patients and it was proposed that the patient education be done to alleviate these problems (Malhotra et al 2016). Similar to our study which indicated the QoL improvement in the psychological aspect, McCorkle et al (2011) reported that self-management training in patients with cancer could improve the management of the symptoms and reduce their anxiety and psychological problems in different courses of treatment and even after treatment, and consequently enhance patients' QoL.…”

“When illness dictates who I am”: A hermeneutic approach to older adults with heart disease

“…Living with HF means living with a failing heart and a body that is both unreliable and unpredictable . When the body's condition changes constantly, when it is weak, fragile, and vulnerable, it reminds the person that life is finite.…”

“…Stable periods are interrupted by rapid deteriorations in heart‐function, often life‐threatening. The main physical symptoms consist of fatigue and breathlessness, which may limit exercise tolerance . In addition to physical limitations, there are also extensive social and existential consequences .…”

“…The main physical symptoms consist of fatigue and breathlessness, which may limit exercise tolerance. 10,11 In addition to physical limitations, there are also extensive social and existential consequences. 12,13 Research suggests that psychosocial factors, such as depression, and self-management of chronic illnesses influence physical health outcomes.…”

“…pointed out, visual as well as unseen signs of illness can imply a difference between how people experience themselves and how the ill person is perceived. For people who are ill, facing an unaccepting world produces feelings of embarrassment due to a sense of segregation.Living with HF means living with a failing heart and a body that is both unreliable and unpredictable 11,39. When the body's condition changes constantly, when it is weak, fragile, and vulnerable, it reminds the person that life is finite.…”