Journal Article

Living with advanced heart failure: A qualitative study

Medina-Perucha, Laura, Checa, Caterina, Verdú-Rotellar, José María, Muñoz, Miguel-Ángel, Berenguera, Anna

2020

Overview

Information about how patients with advanced heart failure (HF) live and cope with their disease remains scarce. The objective of this study was to explore, from phenomenological and holistic perspectives, the experiences of patients suffering from advanced HF, attended at home in the primary care setting in 2018. Qualitative study conducted in 4 primary healthcare centers in Barcelona (Spain). Twelve in-depth interviews were conducted in advanced HF patients, aged over 65 and visited regularly at home. We developed a purposeful sampling, accounting for variability in gender, age, and socioeconomic level. Leventhal's framework was used to analyze the interviews. Participants received insufficient and contradictory information about HF. They talked about their cognitive representation and claimed a better communication with healthcare professionals. Due to their advanced age, subjects considered their daily living limitations to be normal rather than as a consequence of HF. Gender differences in emotional representation were clearly observed. Women considered themselves the keystone of correct family \"functioning\" and thought that they were not useful if they could not correspond to gendered societal expectations. Cognitive coping strategies included specific diets, taking medication, and registering weight and blood pressure. Nevertheless, they perceived the locus of control as external and felt unable to manage HF progression. Their emotional coping strategies included some activities at home such as watching television and reading. Social support was perceived crucial to the whole process. Locus of control in advanced HF was perceived as external. Healthcare professionals should adapt emotional health interventions in patients with advanced HF based on a gender perspective. Social support was found to be crucial in facing the disease. Patients reported poor communication with healthcare professionals.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adaptation, Psychological / Aged / Beliefs, opinions and attitudes / Biology and Life Sciences / Blood pressure / Cardiac patients / Cognitive ability / Congestive heart failure / Development and progression / Emotions / External pressure / Female / Gender / Gender aspects / Health care / Health promotion / Heart failure / Heart Failure - epidemiology / Heart Failure - psychology / Heart Failure - rehabilitation / Humans / Loci / Locus of control / Male / Management / Medicine and Health Sciences / Mortality / Patient outcomes / Patients / Primary health care / Professional ethics / Qualitative research / Quality of Life / Representations / Sex differences / Social interactions / Social Sciences / Social Support / Socioeconomic factors / Spain / Surveys and Questionnaires / Television