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Qualitative
Patients with heart failure had inadequate information about the disease and lacked the tools for optimal self care

https://doi.org/10.1136/ebn.7.4.127

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    Horowitz CR, Rein SB, Leventhal H. A story of maladies, misconceptions and mishaps: effective management of heart failure. Soc Sci Med 2004;58:631–43.OpenUrlCrossRefPubMedWeb of Science

    Q How do patients with congestive heart failure (CHF) perceive and understand the disease and self care?

    DESIGN

    Grounded theory.

    SETTING

    An urban, academic, tertiary care hospital in the US.

    PATIENTS

    19 patients (age range 52–89 y, 53% men) treated for CHF in the hospital, emergency department (ED), or internal medicine or cardiology clinics were identified from a database of inpatient and ambulatory encounters for CHF.

    METHODS

    Patients participated in audiotaped semistructured interviews (mean duration 50 min), which were transcribed verbatim. Questions focused on patients’ illness perspectives, self care, help seeking behaviour, attitudes toward physicians, access to care, definition of and reaction to worsening of their condition, and a detailed description of their most recent critical episode of CHF, if one occurred. Dominant themes were identified by the constant comparative method and compared with the “common sense” model of illness.

    MAIN FINDINGS

    3 dominant themes emerged. (1) Inadequate knowledge of the causes, symptoms, and consequences of CHF (gaps in depth and breadth). Patients did not connect CHF or a “weak heart” to …

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    Footnotes

    • For correspondence: Dr C R Horowitz, Department of Health Policy, Mount Sinai School of Medicine, New York, NY, USA. carol.horowitzmountsinai.org

    • Source of funding: Agency for Healthcare Research and Quality and Mount Sinai Medical Center Auxilliary Board.