Qualitative examination of compliance in heart failure patients in The Netherlands

被引:78
作者
van der Wal, Martje H. L. [1 ]
Jaarsma, Tiny [1 ]
Moser, Debra K. [2 ]
van Gilst, Wiek H. [1 ,3 ]
van Veldhuisen, Dirk J. [1 ]
机构
[1] Univ Groningen, Dept Cardiol, Univ Med Ctr Groningen, NL-9700 RB Groningen, Netherlands
[2] Univ Kentucky, Coll Nursing, Lexington, KY USA
[3] Univ Groningen, Dept Cardiol, Dept Clin Pharmacol, NL-9700 RB Groningen, Netherlands
来源
HEART & LUNG | 2010年 / 39卷 / 02期
关键词
SELF-CARE BEHAVIOR; MEDICATION ADHERENCE; NONCOMPLIANCE; KNOWLEDGE; SURVIVAL; SUPPORT; TRIAL;
D O I
10.1016/j.hrtlng.2009.07.008
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND: Noncompliance with pharmacological and nonpharmacological recommendations is a problem in many heart failure (HF) patients, leading to worse symptoms and readmission. Although knowledge is available regarding factors related to compliance with HF regimens, little is known about patients' perspectives. We investigated patients' reasons and motivations for compliance with HF regimens from their perspective, and we studied how patients manage these recommendations in daily life. The health belief model was used as a framework for this study. METHODS: A qualitative descriptive study was used, and 15 HF patients were interviewed about reasons for compliance, barriers to compliance, interventions that helped them comply with medications, sodium restriction, fluid restriction, and daily weighing. RESULTS: The most commonly reported reasons for compliance included fear of hospitalization and HF symptoms. Barriers to compliance were mainly related to the negative aspects of a regimen, e.g., taste of the food and thirst. Most patients tried to make their lifestyle changes part of the daily routine. Several problems and misunderstandings with the regimen were evident. Patients themselves offered many tips that helped them comply with the regimen. CONCLUSIONS: To improve compliance in HF patients, patient-tailored interventions must be targeted at specific problems and patients' beliefs regarding the regimen, and aim at implementing the regimen into daily life. Healthcare providers need to emphasize the benefits of compliance, motivate patients to comply, and focus on individual barriers to compliance, knowledge deficits, and misunderstandings regarding the regimen. More specific advice about medications and diet is needed. Group interventions, including tips patients themselves provide, might also be useful in helping patients implement the HF regimen in their daily lives. (Heart Lung (R) 2010;39:121-130.)
引用
收藏
页码:121 / 130
页数:10
相关论文
共 35 条
[1]   Executive summary:: HFSA 2006 comprehensive heart failure practice guideline [J].
Adams, KF ;
Lindenfeld, J ;
Arnold, JMO ;
Baker, DW ;
Barnard, DH ;
Baughman, KL ;
Boehmer, JP ;
Deedwania, P ;
Dunbar, SB ;
Elkayam, U ;
Gheorghiade, M ;
Howlett, JG ;
Konstam, MA ;
Kronenberg, MW ;
Massie, BM ;
Mehra, MR ;
Miller, AB ;
Moser, DK ;
Patterson, JH ;
Rodeheffer, RJ ;
Sackner-Bernstein, J ;
Silver, MA ;
Starling, RC ;
Stevenson, LW ;
Wagoner, LE ;
Francis, GS ;
Bristow, MR ;
Cohn, JN ;
Colucci, WS ;
Greenberg, BH ;
Force, T ;
Krumholz, HM ;
Liu, PP ;
Mann, DL ;
Piña, IL ;
Pressler, SJ ;
Sabbah, HN ;
Yancy, CW .
JOURNAL OF CARDIAC FAILURE, 2006, 12 (01) :10-38
[2]  
[Anonymous], 2003, Adherence to Long-Term Therapies: Evidence for action
[3]  
[Anonymous], 1974, HLTH BELIEF MODEL PE
[4]   What do patients know about their heart failure? [J].
Artinian, NT ;
Magnan, M ;
Christian, W ;
Lange, MP .
APPLIED NURSING RESEARCH, 2002, 15 (04) :200-208
[5]   Self-care behaviors among patients with heart failure [J].
Artinian, NT ;
Magnan, M ;
Sloan, M ;
Lange, MP .
HEART & LUNG, 2002, 31 (03) :161-172
[6]  
Bennett S J, 1998, Am J Crit Care, V7, P168
[7]  
Bentley Brooke, 2005, Eur J Cardiovasc Nurs, V4, P331, DOI 10.1016/j.ejcnurse.2005.04.009
[8]  
Buckle J, 2002, Manag Care Q, V10, P30
[9]   Self-care abilities of patients with heart failure [J].
Carlson, B ;
Riegel, B ;
Moser, DK .
HEART & LUNG, 2001, 30 (05) :351-359
[10]   ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008 The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) [J].
Dickstein, Kenneth ;
Cohen-Solal, Alain ;
Filippatos, Gerasimos ;
McMurray, John J. V. ;
Ponikowski, Piotr ;
Poole-Wilson, Philip Alexander ;
Stromberg, Anna ;
van Veldhuisen, Dirk J. ;
Atar, Dan ;
Hoes, Amo W. ;
Keren, Andre ;
Mebazaa, Alexandre ;
Nieminen, Markku ;
Priori, Silvia Gluliana ;
Swedberg, Karl .
EUROPEAN JOURNAL OF HEART FAILURE, 2008, 10 (10) :933-989