<p>Patient Treatment Preferences for Heart Failure Medications: A Mixed Methods Study</p>

Designing and Testing a Treatment Adherence Model Based on the Roy Adaptation Model in Patients With Heart Failure: Protocol for a Mixed Methods Study (Preprint)

10.2196/preprints.13317 ◽

2019 ◽

Author(s):

Shabnam Shariatpanahi ◽

Mansoureh Ashghali Farahani ◽

Forough Rafii ◽

Maryam Rassouli ◽

Amir Kavousi

Keyword(s):

Heart Failure ◽

Content Analysis ◽

Mixed Methods ◽

Conceptual Framework ◽

Treatment Adherence ◽

Mixed Methods Study ◽

Second Phase ◽

Roy Adaptation Model ◽

Adherence To Treatment ◽

Adaptation Model

BACKGROUND Adherence to treatment is an important factor to decrease repeated and costly hospitalization owing to heart failure (HF). The explanation and prediction of medication adherence and other lifestyle recommendations in chronic diseases, including HF, are complex. Theories lead to a better understanding of complex situations as well as the process of changing behavior and explain the reasons for the existence of a problem. OBJECTIVE The aim of this study is to report a protocol for a mixed methods study setting out to investigate the empirical validity of the Roy Adaptation Model as a conceptual framework for explaining and predicting adherence to treatment in patients with HF in Iran. METHODS This mixed methods study consists of an exploratory sequential design to be conducted in 2 phases. The first phase involves identifying the factors associated with treatment adherence in patients with HF through content analysis of the literature and elucidating the perception of participants in the context of Iranian health care where the model of adherence to treatment is designed based on the Roy Adaptation Model. The second phase addresses the interrelationships among variables in the model through a descriptive study using structural equation modeling. Finally, following the summarization and separate interpretation of the qualitative findings and quantitative results, a decision is made about the extent to and ways in which the results of the quantitative stage can be generalized or tested for the qualitative findings. RESULTS Content analysis of the literature in part 1 of the first phase was completed in 2017. Collection and analysis of qualitative data in part 2 of the first phase will be completed soon. The results are expected to be submitted for publication in 2019. Then, the second phase—the quantitative study—will be conducted. CONCLUSIONS The results of this study will provide valuable information about the empirical validity of the Roy Adaptation Model as a conceptual framework for explaining and predicting adherence to treatment in patients with HF, which, to date, have received little attention. The results can be used as a guide for nursing practice and care provision to patients with HF and also to design and implement effective interventions to improve treatment adherence in these patients. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13317

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Patient Adherence to a Mobile Phone–Based Heart Failure Telemonitoring Program: A Longitudinal Mixed-Methods Study (Preprint)

JMIR mhealth and uhealth ◽

10.2196/13259 ◽

2018 ◽

Cited By ~ 10

Author(s):

Patrick Ware ◽

Mala Dorai ◽

Heather J Ross ◽

Joseph A Cafazzo ◽

Audrey Laporte ◽

...

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Mobile Phone ◽

Patient Adherence ◽

Mixed Methods Study

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Exploring Carers’ Experiences of Supporting a Person With Palliative Heart Failure: Positives and Pitfalls of a Mixed-Methods Study

10.4135/9781526419699 ◽

2017 ◽

Author(s):

Katharine Whittingham ◽

Sarah Barnes ◽

Jeremy Dawson

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Mixed Methods Study

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A Mixed Methods Study Exploring the Factors That Facilitate and Impede Heart Failure Self-Care

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2006.06.430 ◽

2006 ◽

Vol 12 (6) ◽

pp. S124-S125 ◽

Cited By ~ 4

Author(s):

Victoria V. Dickson ◽

Janet A. Deatrick ◽

Lee R. Goldberg ◽

Barbara Riegel

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Self Care ◽

Mixed Methods Study

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Clinical decision-making at the end of life: a mixed-methods study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2018-001535 ◽

2018 ◽

Vol 10 (3) ◽

pp. e26-e26 ◽

Cited By ~ 2

Author(s):

Paul Taylor ◽

Miriam J Johnson ◽

Dawn Wendy Dowding

Keyword(s):

Heart Failure ◽

Decision Making ◽

Mixed Methods ◽

End Of Life ◽

Clinical Decision Making ◽

Clinical Decision ◽

Study Groups ◽

Mixed Methods Study ◽

Semistructured Interview ◽

The North

ObjectivesTo improve the ability of clinical staff to recognise end of life in hospital inpatients dying as a result of cancer and heart failure, and to generate new hypotheses for further research.MethodsThis mixed-methods study used decision theory as a theoretical basis. It involved a parallel databases-convergent design, incorporating findings from previously published research, with equal priority to study groups and synthesis by triangulation. The individual arms were (1) a retrospective cohort study of 102 patients with cancer and 81 patients with heart failure in an acute trust in the North of England, and(2) a semistructured interview study of 19 healthcare professionals caring for the same patient groups.ResultsThe synthesis of findings demonstrated areas of agreement, partial agreement, silence and dissonance when comparing the cohort findings with the interview findings. Trajectories of change are identified as associated with poor prognosis in both approaches, but based on different parameters. Management of patients has a significant impact on decision-making. The decision process requires repeated, iterative assessments and may benefit from a multidisciplinary approach. Uncertainty is a defining characteristic of the overall process, and objective parameters only have a limited role in predicting end of life.ConclusionsThe role of uncertainty is important as a trigger for discussions and a defined stage in a patient’s illness journey. This is consistent with current approaches to recognising irreversible deterioration in those with serious illness. This study contributes ongoing evidence that these concepts are vital for decision-making.

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Gender-specific barriers and facilitators to heart failure self-care: A mixed methods study

International Journal of Nursing Studies ◽

10.1016/j.ijnurstu.2009.12.011 ◽

2010 ◽

Vol 47 (7) ◽

pp. 888-895 ◽

Cited By ~ 49

Author(s):

Barbara Riegel ◽

Victoria Vaughan Dickson ◽

Lisa Kuhn ◽

Karen Page ◽

Linda Worrall-Carter

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Self Care ◽

Mixed Methods Study ◽

Barriers And Facilitators ◽

Gender Specific ◽

Specific Barriers

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Jefferson ED-observation Unit Telehealth Transition of Care for Heart Failure (JETT-HFA): A Mixed Methods Study

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2017.07.231 ◽

2017 ◽

Vol 23 (8) ◽

pp. S80-S81

Author(s):

Anna Marie Chang ◽

Irina Sanjeevan ◽

Erin Jennings ◽

Phillip Watts ◽

David J. Whellan ◽

...

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Mixed Methods Study ◽

Transition Of Care ◽

Observation Unit

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A mixed methods study of symptom perception in patients with chronic heart failure

Heart & Lung ◽

10.1016/j.hrtlng.2017.11.002 ◽

2018 ◽

Vol 47 (2) ◽

pp. 107-114 ◽

Cited By ~ 8

Author(s):

Barbara Riegel ◽

Victoria Vaughan Dickson ◽

Christopher S. Lee ◽

Marguerite Daus ◽

Julia Hill ◽

...

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Chronic Heart Failure ◽

Mixed Methods Study ◽

Symptom Perception

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Abstract P167: Patient Perspectives on Experience During Collection, Results Communication and Overall Impact of Patient-reported Outcomes in Heart Failure: A Mixed Methods Study

Circulation ◽

10.1161/circ.141.suppl_1.p167 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Favel L Mondesir ◽

Susan Zickmund ◽

Patrick Galyean ◽

Serena Yang ◽

Grace Perry ◽

...

Keyword(s):

Heart Failure ◽

Mixed Methods ◽

Cardiovascular Health ◽

Well Being ◽

Routine Care ◽

Patient Reported Outcome ◽

Mixed Methods Study ◽

Successful Implementation ◽

Quantitative Survey ◽

Patient Reported

Background: Patient-reported outcome (PRO) assessments are commonly used in clinical heart failure (HF) trials and have been shown to be valid, reliable, sensitive measures of patients’ symptoms, function and quality of life, as well as prognostic of clinical events. To be used in routine care, they also need to be interpretable to providers and patients. Patients’ perspectives on PRO collection and results communication have not been studied. Methods: We conducted a mixed methods study of 24 ambulatory adult HF patients (50% men) who completed PROs as part of care at a HF clinic. Study procedures included (1) qualitative telephone interviews and (2) quantitative surveys following interviews. We employed thematic analysis to analyze and code transcripts using an iterative coding process and descriptive statistics to analyze the survey. Qualitative findings were purposefully linked to quantitative results. Findings: Three themes in qualitative analyses were linked to the quantitative survey: 1. Utility of data: Most participants noted that PRO questionnaires were a useful tool to better understand their health if their providers discussed the results with them, and to provide additional information to help improve their treatment. Ninety-two % (22/24) of participants strongly agreed or agreed (SA/A) and 8% (2/24) were neutral that completing the questionnaires changed their care and improved their health. Ninety-six % (23/24) of participants SA/A and 4% (1/24) were neutral that completing the questionnaires would make evaluation of their well-being more accurate. 2. Length and frequency of data collection: Most participants felt that questionnaire length (13-29 questions completed in 3-8 minutes on average) and frequency of implementation (at every visit) were satisfactory. Sixty-three % (15/24) and 37% (9/24) of participants felt that maximum number of questions should be 5-15 and >15, respectively. Eighty-three % (20/24) and 17% (4/24) of participants felt that maximum time required for completion should be 5 or 10 and >10 minutes, respectively. 3. Communication with providers: Most participants noted that their providers discussed results of PRO questionnaires with them only once or not at all and participants who had this discussion with their providers felt that providers understood their responses. Sixty-two % (15/24), 21% (5/24) and 17% (4/24) of participants SA/A, were neutral and disagreed or strongly disagreed that their providers effectively discussed results of their PROs with them. Conclusions: Qualitative results provided depth and interpretability of quantitative survey results. These results indicate successful implementation and utility of PRO questionnaires in the HF clinic, while highlighting a need for more frequent discussion of PRO results between providers and patients. Further use of PROs may lead to improved cardiovascular health and prognosis in HF.

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