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- Nässtrom, L., et al.
(författare)
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Factors associated with heart failure patients' views of participation in care
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 12:1_suppl
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Participation of patients with chronic heart failure (CHF) in their care is important for improving outcomes. The aim of this study was to explore factors that were associated with patient views of the importance of involvement and participation in care. Methods: Baseline data from 100 CHF patients enrolled to home care in Sweden were used. A linear regression analysis, using enter method, was performed with three subscales (participation, information and needs) of a questionnaire measuring patient views of involvement in care, as the dependent variable. Socio-demographic (age, education, gender, home help service, co-habiting, smoking, alcohol) and clinical characteristics (NYHA-class, co-morbidities measured by Charlson Comorbidity Index), health (EuroQoL 5D), perceived control (Control Attitude Scale), and self-care behavior (European Self-Care Behavior Scale) were included to determine independent factors associated with participation. Results: Sixty-two percent were men, mean age 82 years, the majority (80%) was in NYHA-class III. Patients scored a mean level of 7.6 ± 2.0 (theoretical range 1-10) for the satisfaction of their participation in heart failure care. The regression analysis showed that patients view of the importance of participation was significantly associated with co-habiting (β = 0.25, t = 2.09 p = 0.04) and self-care behavior (β = -0.33, t = -3.44, p < 0.001). These variables explained 22% of the variance of importance of participation. The degree to which patients stated that they had received information about CHF and treatment was significantly related to gender (β = -0.23, t = -2.22, p = 0.03), self-care behavior (β = -0.42, t = -4.34, p < 0.001) and knowledge (β = 0.24, t = 2.25, p = 0.03). These variables explained 21% of the variance of information subscale. Meeting patients need regarding questions and respect was significantly associated with symptoms of depression (β = -0.25, t = -2.29, p = 0.02), self-care behavior (β = -0.37, t = -3.95, p < 0.001) and knowledge (β = 0.23, t = 2.25, p = 0.03). These variables explained 22% of the variance. Conclusion: Patient views of involvement, receiving information, ability to ask questions and being treated with respect were strongly associated with self-care behavior. Other factors influencing satisfaction with involvement and participation were higher level of knowledge, lower degree of depressive symptom, male gender and co-habiting. Interventions that focus on participation to improve self-care seem promising and need to be studied.
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| 2. |
- Näsström, Lena L, et al.
(författare)
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Patients Descriptions of Participation in Structured Heart Failure Home Care
- 2012
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 11:suppl 1, s. S72-S72
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: A growing number of patients with heart failure (HF) will need lifelong care and one option is to provide advanced HF care in the patient’s home. A Euro - pean integrated home care model has been developed and tested in the Netherlands and Sweden. The model pro - vides structured home care with the goal that patients will experience participation, safety and have knowledge about their disease and treatment. The aim of this study was to examine how HF patients, who receive a structured home care, describe participation in the care. Method: Swedish HF patients receiving structured home care at four different settings were included in the study. Strategic sampling was used to reach a variation regard - ing severity of HF, different needs of home-care, age and gender. A total of 19 open ended interviews have been con - ducted. The interviews were analyzed with qualitative con - tent analysis, where categories were developed inductively. Results: In the preliminary findings 5 categories with asso - ciated subcategories emerged on how patients with HF described participation in structured home care. To expe - rience room for communication including having room for dialogue and receiving care-related information was described as important for participation. To have accessi - bility to care through planned home visits or patient initi - ated visits facilitated participation. The patients described participation by engaging in self care and to collaborate with the home care team. To have trust in the home care team with confidence for competence and have continu - ity to meet individual needs was of importance. To have options to make decisions was expressed as a will to make decisions or to entrust decisions to the caregiver, but some - times patients opportunity to choose was restricted due to different aspects and impeded participation. Conclusion/significance of the study: The findings describe different aspects of participation among patients with HF who receive structured home care. Home visits facilitated communication between the patient and care - giver and enables participation. Getting information was an important condition for participation that often was met during home visits. Good accessibility to care increased feeling of participation as well as to meet caregivers of whom they trust. Own desire to make choices vary depend - ing on what choice it regards and also between different individuals. However, several patients expressed a complex situation with several health care contacts, where the opportunity for participation was limited.
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