TY - JOUR
T1 - Comparing Perspectives of Patients, Caregivers, and Clinicians on Heart Failure Management
AU - Ahmad, Faraz S.
AU - Barg, Frances K.
AU - Bowles, Kathryn H.
AU - Alexander, Madeline
AU - Goldberg, Lee R.
AU - French, Benjamin
AU - Kangovi, Shreya
AU - Gallagher, Thomas R.
AU - Paciotti, Breah
AU - Kimmel, Stephen E.
N1 - Funding Information:
Funding: Patient-Centered Outcomes Research Institute pilot grant 1IP2PI000186-02 . Dr Ahmad is supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award no. T32HL069771 and by a 2015 Research Fellowship Award from the Heart Failure Society of America .
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Background Although substantial effort has been devoted to reducing readmissions among heart failure (HF) patients, little is known about factors identified by patients and caregivers that may contribute to readmissions. The goal of this study was to compare the perspectives of HF patients, their caregivers, and their care team on HF management and hospital admissions. Understanding these perspectives may lead to better strategies for improving care during the post-hospital transition and for reducing preventable readmissions. Methods and Results We performed freelisting, an anthropologic technique in which participants list items in response to a question, with hospitalized HF patients (n = 58), their caregivers (n = 32), and clinicians (n = 67). We asked about home HF management tasks, difficulties in managing HF, and perceived reasons for hospital admission. Results were analyzed with the use of Anthropac. Salience indices (measures of the most important words for defining the domain of interest) were calculated. Patients and clinicians described similar home HF management tasks, whereas caregivers described tasks related to activities of daily living. Clinicians cited socioeconomic factors as challenges to HF management, whereas patients and caregivers cited limited functional status and daily activities. When asked about reasons for hospitalization, patients and caregivers listed distressing symptoms and illness, whereas clinicians viewed patient behaviors to be primarily responsible for admission. Conclusions These findings highlight that although some similarities exist, there are important differences among patients, caregivers, and clinicians in how they perceive the challenges of HF management and reasons for readmission. Understanding these differences may be critical to developing strategies to reduce readmissions.
AB - Background Although substantial effort has been devoted to reducing readmissions among heart failure (HF) patients, little is known about factors identified by patients and caregivers that may contribute to readmissions. The goal of this study was to compare the perspectives of HF patients, their caregivers, and their care team on HF management and hospital admissions. Understanding these perspectives may lead to better strategies for improving care during the post-hospital transition and for reducing preventable readmissions. Methods and Results We performed freelisting, an anthropologic technique in which participants list items in response to a question, with hospitalized HF patients (n = 58), their caregivers (n = 32), and clinicians (n = 67). We asked about home HF management tasks, difficulties in managing HF, and perceived reasons for hospital admission. Results were analyzed with the use of Anthropac. Salience indices (measures of the most important words for defining the domain of interest) were calculated. Patients and clinicians described similar home HF management tasks, whereas caregivers described tasks related to activities of daily living. Clinicians cited socioeconomic factors as challenges to HF management, whereas patients and caregivers cited limited functional status and daily activities. When asked about reasons for hospitalization, patients and caregivers listed distressing symptoms and illness, whereas clinicians viewed patient behaviors to be primarily responsible for admission. Conclusions These findings highlight that although some similarities exist, there are important differences among patients, caregivers, and clinicians in how they perceive the challenges of HF management and reasons for readmission. Understanding these differences may be critical to developing strategies to reduce readmissions.
KW - Heart failure
KW - patient-centered care
KW - qualitative research
KW - readmissions
KW - transitional care
UR - http://www.scopus.com/inward/record.url?scp=84959557051&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959557051&partnerID=8YFLogxK
U2 - 10.1016/j.cardfail.2015.10.011
DO - 10.1016/j.cardfail.2015.10.011
M3 - Article
C2 - 26505810
AN - SCOPUS:84959557051
VL - 22
SP - 210
EP - 217
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 3
ER -