scholarly journals Patients’ experiences of a nurse-led home-based heart failure self-management programme: Findings from a qualitative process evaluation (Preprint)

10.2196/28216 ◽  
2021 ◽  
Author(s):  
Wenru Wang ◽  
Ying Jiang ◽  
Karen Wei Ling Koh ◽  
Hadassah Joann RAMACHANDRAN ◽  
Yee Kian Tay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Process Evaluation ◽  
Management Programme ◽  
Self Management ◽  
Home Based ◽  
Qualitative Process Evaluation

scholarly journals Patients’ experiences of a nurse-led home-based heart failure self-management programme: Findings from the process evaluation (Preprint)

2021 ◽  
Author(s):  
Wenru Wang ◽  
Ying Jiang ◽  
Karen Wei Ling Koh ◽  
Hadassah Joann RAMACHANDRAN ◽  
Yee Kian Tay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Self Care ◽  
The Elderly ◽  
Management Programme ◽  
Self Management ◽  
Structured Interviews ◽  
Additional Information ◽  
Home Based

UNSTRUCTURED Aims: To explore participants’ perspectives on a nurse-led home-based heart failure self-management programme (HOM-HEMP) in a randomized controlled trial conducted in Singapore to gain insight into the effectiveness or failure of the study intervention. Design: A descriptive, qualitative approach was adopted. Method: English or Chinese-speaking participants from the intervention arms were recruited through a purposive sampling method from January 2019 to July 2019. Individual, face-to-face, semi-structured interviews were conducted with 11 participants. All the interviews were audio-recorded and transcribed verbatim, with the identifiers of the participants omitted to ensure confidentiality. The thematic analysis approach was used for identifying, analyzing and reporting the patterns (themes) within the data. Results: Six themes emerged from the process evaluation interviews and were categorized according to Donabedian’s structure-process-outcome framework as "intervention structure," "intervention process," and "intervention outcome". These six themes were manageability of intervention, areas for improvement, benefits of visiting, personal accountability in self-care, empowered with knowledge and skills in self-care after the intervention, and increased self-efficacy in cardiac care. Conclusion: The findings of the process evaluation provided additional information about participants' perceptions and experiences with the HOM-HEMP intervention. While home visit may be perceived as resource intensive, it remains the preferred way of engagement for most of the elderly patients. The nurse plays an important role in promoting heart failure self-care. The process of interaction with the patient can be an important empowering process for self-care behaviour changes. Impact: Process evaluation is an important step in the evaluation of a complex intervention. It allows researchers and practitioners to better understand the mechanism by which an intervention generates impact. Therefore, future intervention programmes can leverage on these mechanisms and adapt them to different contexts for better intervention effectiveness.

scholarly journals Process evaluation of a randomised pilot trial of home-based rehabilitation compared to usual care in patients with heart failure with preserved ejection fraction and their caregiver’s

2020 ◽  
Author(s):  
Karen Smith ◽  
Chim Lang ◽  
Jenny Wingham ◽  
Julia Frost ◽  
Colin Greaves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Process Evaluation ◽  
Treatment Options ◽  
Pilot Trial ◽  
Qualitative Assessment ◽  
Intervention Fidelity ◽  
Preserved Ejection Fraction ◽  
Home Based

Abstract Background: Whilst almost 50 percent of heart failure (HF) patients have preserved ejection fraction (HFpEF), evidence-based treatment options for this patient group remain limited. However, there is growing evidence of the potential value of exercise-based cardiac rehabilitation. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial. Methods: Process evaluation sub-study parallel to a single centre (Tayside, Scotland) randomised controlled pilot trial with qualitative assessment of both intervention fidelity delivery and HFpEF patients’ and caregivers’ experiences. The REACH-HF intervention consisted of self-help manual for patients and caregivers, facilitated over 12 weeks by trained healthcare professionals. Interviews were conducted following completion of intervention in a purposeful sample of 15 HFpEF patients and seven caregivers.Results: Qualitative information from the facilitator interactions and interviews identified three key themes for patients and caregivers: (1) understanding their condition, (2) emotional consequences of HF, and (3) responses to the REACH-HF intervention. Fidelity analysis found the interventions to be delivered adequately with scope for improvement in caregiver engagement. The differing professional backgrounds of REACH-HF facilitators in this study demonstrate the possibility of delivery of the intervention by healthcare staff with expertise in HF, cardiac rehabilitation or both. .Conclusions: The REACH-HF home-based facilitated intervention for HFpEF appears to be a feasible and a well-accepted model for the delivery of rehabilitation, with the potential to address key unmet needs of patients and their caregivers who are often excluded from HF and current cardiac rehabilitation programmes. Results of this study will inform a recently funded full multicentre randomised clinical trial.Trial registration: ISRCTN78539530 (date registration 7th July 2015) http://www.isrctn.com/ISRCTN78539530

scholarly journals Process evaluation of a randomised pilot trial of home-based rehabilitation compared to usual care in patients with heart failure with preserved ejection fraction and their caregiver’s (REACH-HFpEF pilot study)

2020 ◽  
Author(s):  
Karen Smith ◽  
Chim Lang ◽  
Jenny Wingham ◽  
Julia Frost ◽  
Colin Greaves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Rehabilitation ◽  
Process Evaluation ◽  
Treatment Options ◽  
Pilot Trial ◽  
Randomised Clinical Trial ◽  
Qualitative Assessment ◽  
Preserved Ejection Fraction ◽  
Home Based

Abstract Background: Whilst heart failure (HF) with preserved ejection fraction (HFpEF) affects almost 50 percent of the HF population, evidence-based treatment options remain limited. However, there is growing evidence of the potential value of exercise-based cardiac rehabilitation. This study reports the process evaluation of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention for HFpEF patients and their caregivers conducted as part of the REACH-HFpEF pilot trial. Methods: Process evaluation sub-study parallel to a single centre (Tayside, Scotland) randomised controlled pilot trial with qualitative assessment of both intervention fidelity delivery and HFpEF patients’ and caregivers’ experiences. The REACH-HF intervention consisted of self-help manual for patients and caregivers, facilitated over 12 weeks by trained healthcare professionals. Interviews were conducted following completion of intervention in a purposeful sample of 15 HFpEF patients and 7 caregivers.Results: Qualitative information from the facilitator interactions and interviews identified three key themes for patients and caregivers: (1) understanding their condition, (2) emotional consequences of HF, and (3) patients’ and caregivers’ responses to the REACH-HF intervention. The differing professional backgrounds demonstrate the possibility of delivering REACH-HF by either existing HF or cardiac rehabilitation services of a combination of the two.Conclusions: The REACH-HF home-based facilitated intervention for HFpEF appears feasible and well accepted model for delivery of a cardiac rehabilitation intervention, with the potential to address key unmet needs of patients and their caregivers who are often excluded from service provision and current CR programmes. Results of this study will inform a recently funded full multicentre randomised clinical trial.Trial registration: ISRCTN78539530 (date registration 7th July 2015) http://www.isrctn.com/ISRCTN78539530

Sign in / Sign up

Export Citation Format

Share Document