Patient preferences for heart failure education and perceptions of patient–provider communication

Abstract

Patient preferences for heart failure education and perceptions of patient-provider communication Objective: For people managing chronic illness, such as heart failure, adequate health literacy is crucial to understand the complex information that underpins self-care, yet evidence suggests poor understanding in this patient population. To better understand patients' heart failure comprehension and why knowledge gaps may exist, this study sought to explore perceptions of patient-provider communication and ascertain unmet educational needs and preferences. Methods: Semi-structured in-depth interviews were conducted with 15 symptomatic inpatients with heart failure. Data collection and analysis occurred simultaneously until saturation was reached. Transcripts were analysed using thematic analysis. Results: Participants relied heavily on providers for HF information and support, expressed numerous unmet educational needs and had mixed feelings about quality of communication. Participants expressed the need for credible, tailored heart failure information that accounted for comorbid conditions and preference for face-to-face information delivery. Knowledge gaps included heart failure pharmacotherapy, symptom appraisal and management, cause and chronicity of heart failure, and a specific action plan for heart failure symptom exacerbation. Barriers to effective patient-provider communication included providers using complex medical terminology, lack of adequately detailed information, relationships that did not foster open communication and participants' memory problems. Conclusion: Gaps in knowledge and poor communication may indicate inadequate availability of multidisciplinary heart failure management programmes and/or fidelity to guideline recommendations. Practice implications: Evaluating heart failure management programmes is important to ensure consistent delivery of best-practice education and care. Nurses play a key role in the delivery of patient-focused health information.

Development of Core Educational Content for Heart Failure Patients in Transition from Hospital to Home Care: A Delphi Study

“…Treatment of HF patients can be broadly divided into medication treatment, medical procedure and surgical treatment, and lifestyle adjustment [ 23 , 25 , 26 ]. In general, since most patients with HF are treated with two or three different medicines, an understanding of HF medications is required by patients [ 40 ] and patients must also be educated on the importance of medication adherence to ensure compliance [ 41 ]. Many HF patients are older aged adults and lack an understanding of the heart and its related organs (lungs, kidneys, and blood vessels), and the HF diagnosis-related instruments [ 37 , 40 ].…”

“…In general, since most patients with HF are treated with two or three different medicines, an understanding of HF medications is required by patients [ 40 ] and patients must also be educated on the importance of medication adherence to ensure compliance [ 41 ]. Many HF patients are older aged adults and lack an understanding of the heart and its related organs (lungs, kidneys, and blood vessels), and the HF diagnosis-related instruments [ 37 , 40 ]. Therefore, to help them understand the clinical course of HF, we need easy-to-understand images to explain the mechanism of edema, a major symptom of HF, and thus, the heart structure with related organs was included in the educational material.…”

“…In Section 2, “Medication treatments of HF”, we included all medications used to treat HF and tried to provide an easy explanation of the drugs’ mechanism of action in treating or controlling HF using cartoon images [ 40 ]. Even though so many different types of drugs are used in HF patients [ 23 , 25 ], it is inappropriate to provide patients with information on all drugs.…”

Filling a gap in standardized nursing terminology. Development of a new nursing diagnosis proposal on heart failure self‐care

“…In addition, many situations—such as ineffective communication, poor relationship, or lack of continuity between the client and the healthcare professionals—may compromise the efficacy of nursing care (Ivynian et al., 2020; Sterling et al., 2018). Other psychosocial, behavioral, and socioeconomic relevant factors outside the patient's control or ability (e.g., lack of access to care, inability to afford prescribed medications) should be taken into account by nurses as potential obstacles to performing self‐care behaviors (Reilly et al., 2015).…”

CE: Guideline-Directed Cardiac Devices for Patients with Heart Failure

“…She gives him diet instructions with sodium restriction and shows him how to read a food label. She also teaches him how to recognize worsening symptoms, such as difficulty breathing, increased feet or ankle swelling, increased fatigue, or frequent coughing37—and to call his provider if he experiences any of these.…”