Heart failure patients' descriptions of participation in structured home care

• Published in: Health expectations : an international journal of public participation in health care and health policy Vol. 18; no. 5; pp. 1384 - 1396
• Main Authors: Näsström, Lena M., Idvall, Ewa A‐C., Strömberg, Anna E.
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.10.2015; John Wiley and Sons Inc
• Subjects: Access; Aged; Aged, 80 and over; Competence; Content analysis; Decision Making; Disease control; Disease management; Domiciliary visits; Feasibility; Female; Health; Health education; Health information; Heart failure; Heart Failure - therapy; home care; Home Care Services; Home health care; Humans; Interviews as Topic; involvement; Male; Middle Aged; Original; Original Research Papers; Patient communication; Patient Participation; Patients; Professional-Patient Relations; Qualitative analysis; qualitative method; Qualitative Research; Respondents; Self care; Self Care - psychology; Suffering; Sweden; Treatment preferences; Sweden; heart failure; home care; involvement; qualitative method; patient participation; decision making
• ISSN: 1369-6513; 1369-7625; 1369-7625
• DOI: 10.1111/hex.12120

Background To strengthen the patient's position in health care, patient participation has been decreed in policy documents and legalizations. For patients suffering from heart failure, self‐care is an important part of disease management and participation is crucial to succeed with this. Objective To examine how heart failure patients receiving structured home care described participation in the care. Design Qualitative study. Setting and participants Thirteen men and six women, aged between 63 and 90 years, were interviewed. The informants received structured home care at four home care units in Sweden. The interviews were analysed using qualitative content analysis. Results Five categories with associated subcategories describing participation in care were identified: communication between patients and health‐care professionals (HCPs) including time and space for dialogue and exchange of care‐related information, accessibility to care through awareness of the plan for home visits or feasibility to initiate home visits, active involvement in care by engaging in self‐care and collaboration with HCPs, trustful relation with HCPs, with confidence in competence and individually adapted care, options for decision making, by making decisions or entrusting decisions. Conclusions Patient participation could be strengthened through structured home care. Participation was facilitated when there was a balance between the patient's own preferences to influence care and the health‐care professional's actions and values and the organization of care. Barriers to participation could depend on the health‐care organization, lack of continuity and confidence in HCPs.