Impact of Heart Attack on Patient and Family
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The implications of living with heart failure; the impact on everyday life, family unit support, co-morbidities and admission to healthcare: a secondary qualitative assay
BMC Family unit Practice volume 17, Article number:139 (2016) Cite this commodity
Abstruse
Background
The aim of this report was to employ secondary analysis to interrogate a qualitative data prepare to explore the experiences of patients living with heart failure.
Methods
The data-set comprised interviews with 11 patients who had participated in an ethnographic study of eye failure focusing on unplanned infirmary admissions. Following an initial review of the literature, a framework was developed with which to interrogate the data-set. This was modified in light of analysis of the first 2 interviews, to focus on the rich information effectually patients' perceptions of living with centre failure, managing co-morbidities, accessing healthcare and the role of their family unit and friends, during their illness journey.
Results
Respondents described how the symptoms of middle failure impacted on their daily lives and how disruption of routine activity due to their symptoms caused them to seek medical care. Respondents disclosed the difficulties of living with other illnesses, in addition to their heart failure, particularly managing multiple and complex medication regimes and negotiating multiple appointments; all expressed a desire to return to their pre-morbid, more than independent lives. Many respondents described uncertainty effectually diagnosis and delays in communication from their healthcare providers. The importance of family support was emphasised, simply respondents worried about burdening relatives with their affliction.
Conclusion
Living with centre failure causes disruption to the lives of sufferers. Facilitation of access to healthcare, through good communication between services and having a strong back up network of both family unit and clinicians can reduce the impact of heart failure on the lives of the patient and those around them.
Peer Review reports
Background
A chronic illness, by definition, is a disease which persists for a long period of time and tin can cause continuous or episodic periods of incapacity [1]. Coffin 1982 describes the effects of chronic illness as 'biographical disruption' to everyday life, and non merely disruption to the private suffering with the illness, but their families and wider social network [ii]. Patients and their families may seek out data, support, and the most effective strategies to manage their symptoms, in the effort to minimise potential future disruption [3].
Heart failure is prevalent in the UK [4]; common symptoms include breathlessness, peripheral oedema and fatigue, all of which interfere with daily life [5]. Patients typically have multiple chronic co-morbidities, each of which may have a complex treatment authorities [6]. Cocky-direction of multiple chronic illnesses, educating patients to monitor their ain health and being able to recognise illness severity are current features of healthcare policy [7].
Symptom unpredictability has been reported to leave patients feeling helpless and completely dependent on those around them, leading to a lack of control of the illness and an increased burden on family unit and the healthcare arrangement [8]. Responsibility for care may shift from the patient to their spouse or firsthand family. In these circumstances the patient may prefer the 'sick role', relying on their family for support both with their illness and previous responsibilities [9]. Information technology has been reported [10] that in patients with greater levels of family support, confidence between members is increased, and family unit ties strengthened, in times of need such as ill-health. Therefore, congruent beliefs near the illness are important in order to accomplish successful family functioning and to heighten patient well-existence [10].
Previous studies exploring heart failure and patients' quality of life suggest that balancing handling regimens of multiple co-morbidities and the boosted symptoms from co-morbidities could be extremely difficult for patients [5, 11]. Challenges for patients managing multiple illnesses include; lack of intendance co-ordination, a greater need for back up and more time needed to develop techniques to manage multiple illnesses [nine]. Patients' agreement of eye failure and how to manage has been reported as poor, leading to a cycle of hospital (re) admissions, which is non but confusing for the patient but too places significant pressure on secondary intendance and increases healthcare cost [5].
There appears to be petty consideration to the interaction between different health conditions by healthcare professionals. However, patients take been reported to manage their multiple illnesses by active weighing upwardly of possible handling options beyond their different wellness atmospheric condition [11, 12]. The caste of understanding (or otherwise) in prioritising multiple conditions between the patient and clinician and between dissimilar clinicians and the patient, tin affect subsequent self-management, such equally treatment adherence and hereafter therapeutic relationships [viii].
The relationship between a patient and their dr. is the foundation for constructive direction of chronic illness [13, xiv]. An effective doctor-patient relationship is founded on high quality communication, which could exist divers every bit the promotion of information gathering, agreement on therapeutic options and patient support [fifteen]. Effective arrangement inside the healthcare system can provide continuity within clinical relationships [xvi]. Conversely, poor advice tin can issue in patient uncertainty, confusion and worry, reducing a patient'southward quality of life and power to recover from illness. In vulnerable patients the doc-patient human relationship is important as patients may experience increased dependence on the doctor [12, 17]. Effective communication can ensure that doctors are aware of the patients' expectations, aid to regulate their emotions and facilitate the understanding of information, which will ultimately pb to greater patient satisfaction [18]. Clinician and nurse availability can give patients a sense of security, as the patient understands that fourth dimension and effort has been invested to adjust them and provide information or reassurance [xix].
This paper focuses on the secondary analysis of data collected from HoldFAST, a multicentre report including Bristol, Oxford and Keele Universities, which was funded by the National Found for Health Research. The aim of collecting qualitative data from these participants was to gain an in-depth insight into the pathways towards, and reasons for, unplanned infirmary admissions in patients with centre failure. The HoldFAST study aimed to explore patients' experiences from multiple standpoints using ethnographic methods, combining observations, interviews and documentary data sources [20]. This paper reports a secondary assay which focused on patients' perspectives of living with and managing center failure and the impact of the management of multiple illnesses, the importance of the doctor-patient relationship, and the role of family and friends, illuminating areas of heart failure care and patient feel that have been insufficiently explored in the previous literature.
Methods
This report involved secondary assay of a data-prepare collected as part of a wider multi-centre investigation, to gain an in-depth insight into the pathways towards, and reasons for, unplanned hospital admissions in patients with center failure. [20] Primary analysis of the whole data-set had already been conducted, [20] simply the data-set comprising patient interviews had non been analysed independently.
For the HoldFAST report, a semi-structured topic guide had been developed past the research team, which immune respondents to express their experiences of having heart failure forth unlike points in the clinical pathway using a technique referred to as a 'patient-led ethnography', which captures views and experiences during important or critical episodes during the patient's illness journey. Each interview was carried out within the participants' homes, digitally recorded and transcribed for thematic analysis by the primary researchers. All the same, shorter 'debrief' discussions were held with patients during 'critical moments' such as at clinic appointments, GP visits, conversations on the mode to or from hospital. The pb researcher (SMc) kept in regular contact with patients who were asked to notify the research team prior to any planned clinic appointments or 'eventful' disease episodes that they experienced in club to trigger a visit or telephone discussion by the researcher. This approach provided insights into patients' naturally evolving disease experiences related to their heart failure journeying, and enabled the researchers to tape events as they happened, or shortly afterwards. This technique is dissimilar from traditional unmarried interviews, every bit information technology helped to capture an evolving storyline in the patients' lives beyond a flow of up to 6 months, to offering a deeper insight into their daily and weekly disease experiences and contacts with health services, particularly around hospital access.
Ethical approval for the HoldFAST study was granted by NRES Committee S West - Frenchay, Bristol, and local approvals were obtained from Staffordshire Cluster of PCTs Enquiry Management and Governance Role, and the Research & Development Section of Academy Hospital of North Staffordshire NHS Trust. The original consent form for the HoldFAST study asked the patient to consent to the utilize of information for farther research within the research institutes.
The aim of this secondary analysis was to interrogate a single information-set (the 'get out interviews) from an contained perspective, in club to critically evaluate the data with the aim of identifying fundamental experiences and impact of living with center failure and to gain a deeper agreement, and maximise use, of the information [21, 22].
Data drove
The data comprised anonymised interview transcripts from the participants who had been identified and recruited for the HoldFAST written report from a cardiology ward and specialist center failure ambulatory clinic from three geographical locations within the UK; the Midlands, South Central and the South West of England. Patients with severe or difficult to manage middle failure from the Midlands and South Fundamental and less 'severe' patients from a primary care centre from the Southward West of England were approached. They were given information leaflets and given at least 24 h to consider participating before being contacted past members of the research team. From those willing to participate (N = 31) written consent was taken. Ix patients (4 males and 5 females with a mean historic period = 71.2 years) and 3 female carers were recruited for the master study. 2 patients and iii carers also agreed to write diaries. Two other patients (1 male, i female) were not recruited into the main HoldFAST study but agreed to participate in unmarried in-depth interviews. The data used for the current assay were nerveless over an 11 calendar month flow during 2011–2013 and focused on one of the three research sites. The interviews presented in this paper were conducted at the end of the study, (we called these 'exit interviews') and encouraged patients to reflect on their illness journeying since their diagnosis as well as on their experiences prior to diagnosis. The time of the exit interview from the initial invitation to participate in the written report, was upwards to 6 months.
Analysis
For this study, a secondary analysis of the interview data was conducted. This involved re-visiting the ten leave interviews and 1 set of field notes for an interview which wasn't audio recorded. Post-obit familiarisation with the information-set, each interview was read thoroughly by MF, SMc and CCG and the most prominent themes were identified and agreed. Linking this with the existing literature, a framework was adult past MF, SMc and CCG (see Table 1) to interrogate the data-prepare.
The initial framework included the questions:
Every bit coding of the first ii interview transcripts progressed using the framework (Table 1), and with word inside the supervisory team, information technology became apparent in that location was rich information on the impact of symptoms on everyday life, and narrative about relationships with healthcare practitioners, access to care and the importance of patients' back up networks. Thus, the framework used was modified to include these themes (Table 2) and used interrogate the remainder of data-ready.
The revised framework included the questions:
High level codes, which highlighted repetitive themes, were identified within the transcripts, using the framework through an iterative method. Regular word with the supervisory team (CCG and SM) ensured agreement on coding and that whatsoever discrepancies were resolved. These themes had not been previously developed in the master assay (as this information-set had not been analysed on information technology's own) and thus our analysis provided new insights from the aforementioned data set.
Results
Using the to a higher place framework a number of prominent themes volition be presented. These are: 1) the impact of illness on everyday life, 2) the role of family and friends in providing support, 3) relationships with health professionals, 4) managing multiple illnesses, and 5) access to healthcare. Each theme is presented and supported by illustrative information, followed by the participant's unique identifier.
Table three gives details of the study participants. Information is given to illustrate each of the themes presented.
Implications of living with heart failure
Impact of disease on everyday life
Participants described the impact on their lives of living with centre failure symptoms. They described how they experienced the symptoms of heart failure and their impact on everyday routines.
"Because actually yous know information technology'southward a condition and sometimes y'all know, the fluid, evidently my ankles injure…" KP8
"I'd taken the dog for a walk and something started and I thought whatever'south the affair this foreign and so I said to my husband, I'k non well…" KP1
Some participants reported that they had non initially recognises their symptoms as being related to heart failure, and therefore were tedious to deed upon them at the start of their disease. Following receipt of a diagnosis, participants and their family described heart failure symptoms as a 'disruption' to their lives, which made them have their affliction and the limitations of their condition.
"I call up I didn't feel equally hungry and everything seemed to be sticking you know kind of thing, you lot know, when yous've sort of eaten too much…" KP1
Participants reported a wide range of symptoms, which individually may non cocky-evidently signal heart failure. These symptoms limited the patients' quality of life and impacted on them and their families. Educating patients with heart failure to recognise early symptoms will empower them with the noesis to identify exacerbations and engage in preventative self-management.
Managing multiple illnesses
The bulk of respondents stressed the affect of other health problems in combination with their heart failure. They described the difficulty of differentiating the symptoms they were experiencing as a result of the eye failure from their other co-morbidities or side-effects of medications.
"…just then y'all don't know if information technology'southward a cough…and so you don't know whether it's a coldy-cough or whether it's something to do with the medication." KP6
"..all the symptoms were there for heart failure but and then the symptoms were there like me blood glucose dipped down to two point something then you know it was a mixture of…" KP3
The main bear upon of their other illnesses seemed to be the difficulty of managing complex medication regimes.
"While he's all the same messing with the gout medicine he thinks they'll have to go along me on…"KP5
"…of course I was on tablets already for high blood pressure, which I've been on for years, and they changed all those". KP7
Some respondents reported that they felt that other health conditions they had seemed to be de-prioritised during their treatment for center failure. This sometimes affected respondents' feelings towards other healthcare professionals, and they suggested that their co-morbidities were not given equal attending as their heart failure.
"They were more concerned almost the lungs to be honest with you than they were about the heart so…I suppose you become from ane of them." KP2
"I was very worried because I thought well I knew I'd got loftier blood force per unit area just I thought if they accept me off these tablets what will happen you know about my loftier blood pressure but he said 'forget all well-nigh that, we'll put you on these others' which they did." KP1
Respondents also discussed the difficulties in managing multiple appointments for their dissimilar weather condition.
"I remember the 9 thursday of October that's in my kidneys… Aye information technology'due south every about 4 months, vi months, only depends what's going on next week… I was too upset about this cancer to be honest but she thinks, er, I probably won't get any treatment because I'yard too poorly but I'll have to look to run into what he says on Tuesday". KP9
Many of the respondents had multiple illnesses; nonetheless they suggested that their heart failure was often prioritised past clinicians, who considered it equally having a greater impact on morbidity and mortality.
The role of family unit and friends
All of the respondents interviewed discussed their feelings about having or not having a back up network of family unit and/or friends during their disease and the bear on this had on them emotionally.
"But my eldest lad, [name of KP10's elder son], said you never saw yourself dad, you looked bloody terrible..... that was when they took me… to the blow and emergency" KP10
"If [proper noun of KP7's son] and [name of KP7'southward son's partner] hadn't had been and so proficient, you know, coming down. They'd come up and make clean through for me a few times er during that menstruum 'cause they got on pinnacle of me." KP7
Some respondents reported family unit members who took a very proactive role in trying to assistance participants, either past contacting the health services on their behalf or suggesting decisions for the patient against other doctors' recommendations.
"I've got a very good friend whose hubby is a medical consultant and I did speak to him considering I was so concerned and he actually gave me a lot of advice of what to practise and what to say to the GP if she didn't do, erm, what he'd actually advised she should do." KP4
KP11s' girl repeatedly asked to see the doctor to seek out explanations-(KP11s' field notes).
But one respondent identified a lack of immediate family unit support, and she described a sense of worry and lack of confidence in managing her heart failure:
"I hope to go shopping but I only feel that I need somebody with me where it's never bothered me earlier…just I used to, you lot know never a care in the world really despite of all my problems." KP1
In contrast, the other respondents with stiff back up networks of family unit and friends, appeared to accept their diagnosis of heart failure more quickly and described looking to get back to their normal everyday lives building on that support.
"I'yard on top of it over again now… I've taken charge of information technology all myself… They cut me lawns for me and that sort of thing, because doing the mowing at present – that does kill me ....Only equally far as the house is concerned, and washing is concerned, I'm doing all me own" KP7
Family and friends were seen to be key to patients' recovery.
Relationships with healthcare professionals
Respondents expressed a spectrum of opinions well-nigh the care they had received from their healthcare professionals. They showed appreciation for specialist doctors and specialist heart failure nurses, who were perceived to spend a greater amount of fourth dimension providing information both to the participants and their families.
"He's marvellous… we thought that was really proficient, because if he spends time with everybody like that then it'southward like the old-fashioned doc, isn't it actually? Instead of just packing yous off…" KP6
"..but they explained what was going on, which to me is good you know because they tin can explain things and I won't worry" KP10
"He'southward lovely, I always had a buss and a hug when I go in and out the clinic… Well he'southward looked afterwards me for the final half dozen years with Dr Fifty so, er, we know one some other" KP9
However, some respondents were less positive about primary intendance professionals. A number of respondents reported an apparent delay in diagnosis past their GP, which had negative furnishings on their human relationship.
"That was while the doctors were maxim chest infections… so they weren't spotting the fluid." KP5
"Oh it's your asthma, here....he didn't even examine me....it'south only when my legs started, my ankles started swelling and we insisted." KP4
Those respondents, who expressed some negative feelings towards particular clinicians, described how they were wary virtually future encounters and the confidence the respondents had in those clinicians.
"he said he wouldn't go to the doctors because you felt that, y'all know, if they just give y'all another inhaler." KP4
"But I wasn't my normal GP he only left it at that, I always wonder, listen you lot I don't retrieve it could take been avoided what happened." KP1
Respondents who reported consultations with clinicians who were non their registered chief care md, described negative feelings towards the doctor, and attributed any filibuster in receiving appropriate care to this medico. Respondents who described such negative encounters with clinicians reported this as a bulwark to seeking care in the futurity.
Admission to healthcare
Respondents expressed a range of views about the care and support they received from the different healthcare professionals and well-nigh admission to and interaction with the healthcare system.
Respondents described a lack of pro-active contact from the healthcare system, both from hospitals and primary intendance, regarding scheduling appointments and the adjacent stages in their care pathway. These respondents described a degree of dubiousness what would happen adjacent and whose responsibility information technology was to monitor and back up them. They expressed incertitude about whose responsibility it was to initiate communication, when hospitals or master care failed to send information to the respondents every bit they had said they would.
"…oh honey could be 18 months agone something like that…I think the doctors must have sent me but I never heard annihilation from that at all and then I don't know". KP1. This respondent also went on to say, "the doctor's surgery perhaps could accept shown a bit more back up but on the other paw perhaps I should have just rung and you know, so perhaps it'south upward to me".
"I went to see, er, Dr E, er, whose first words when I went into the appointment were 'Why are you here?' and I said, 'I haven't a inkling considering I don't know who you are or what you exercise or anything', and he said 'No I don't know who y'all are either'". KP5
Other respondents, however, described certain healthcare professionals equally being uncommonly efficient at facilitating straight access to themselves or other parts of the healthcare system apace. In these instances, patients expressed appreciation for the effectiveness of that particular medico or nurse, which led to anticipation of a positive future relationship between the healthcare professional and the patient.
"'I remember the radiographer at the hospital said it would be ten days for the results'…sent information technology direct through....everything marvellous" KP6
Those respondents who felt that their concerns had been dismissed by particular clinicians, or that they had not been listened to reported a negative impact on the hereafter relationship with those clinicians.
Discussion
Summary of results
All participants described the symptoms of heart failure equally a disruption to their everyday life and limited their ability to perform routine activities, which led to frustration and a significant loss of confidence, and ultimately acquired patients to question their own identity and self-esteem.
Factors which can influence how middle failure may disrupt patients' lives include the speed and efficiency of a diagnosis and treatment. Many respondents described initial misdiagnoses of their disease, which led to significant delays in the correct treatment being instituted. As a consequence of perceived delays in diagnosis, respondents reported losing confidence in their doctors' abilities to provide the right care for them, which impacted on future help-seeking. Lack of advice between the healthcare system and the participants led to further confusion and business organisation.
The majority of respondents mentioned how their family and friends played a function in supporting the management of their illness. Where respondents had some medical expertise in the family, they reported like-minded with their families' stance over that of the doctors.
For the one respondent who didn't have immediate family support, she reported a greater loss of confidence and contrasted her illness journey to that of her husband, where she perceived that had received more support and care. This respondent, along with the others, was interested in returning to 'normal' and regaining their independence; her lack of confidence, however, impacted on her ability to self-manage and self-monitor her symptoms.
Comparing with previous literature
The findings from this study support previous studies conducted on the patient's experiences of living with middle failure. [23] In add-on, our findings support Coffin's description of a 'biographical disruption', with symptoms and management leading to lives disrupted from their everyday 'norm' [2, 24].
The claiming of managing multiple conditions was described, with patients responding to different exacerbations of their illnesses and prioritising the management of their conditions based on the upshot each illness had on their daily lives, and individual clinicians being seen to prioritise the illness which they were expert in treating [8].
The results of this analysis highlight the importance of the doctor-patient human relationship, with the findings consistent with those of other studies, as patients described a lack of trust or confidence in doctors that were not their 'usual' doctor [15, 16]. As well as doctors 'knowing' their patients, the patients had a sense of security 'knowing' their doctors, demonstrating the importance of experience and trust between a doctor and their patient, since it provides a gateway to accessing healthcare. Respondents seemed to assign blame to the doctors who were not their 'usual' healthcare provider, if annihilation went incorrect, or to contemplate if things would have been done differently if their 'usual' doctors had been involved instead.
Poor communication tin can touch on on patient care and outcomes [25]. Respondents described receiving unclear directions nearly their care pathway and ongoing support from their diagnosing doctors, and were confused about whose responsibility it was to initiate advice between hospital and primary care.
All respondents were positive near the specialist heart failure nurses, who were perceived to have more time to dedicate to patients, for explaining their illness and providing back up, which was greatly appreciated by the respondents. This additional fourth dimension allowed for greater patient education on anticipatory care, which involved identifying symptoms that the participant should look out for, to indicate an exacerbation of their illness. Specialist nurses are idea to accept greater opportunities to provide instruction and support to patients and are able to liaise with unlike clinicians coordinating care to participants with complex multiple co-morbidities [26]. The results from this report reinforce the need for specialist eye failure nurses in the continued management, education and back up of patients.
The findings are consequent with previous qualitative studies reporting that who found that respondents described a sense of burden on those around them, but agreed that information technology would be worse if they were lonely [5]. Some respondents described 'trying to make the best of information technology' and trying as best they could to get back to normality, with the help of their loved ones.
Secondary analysis of the HoldFast data has provided support for results from previous qualitative studies and has highlighted how the difficulties in advice between health professionals across sectors impact on the management of patients every bit a whole.
Strengths and limitations
The main strength of this study is that a secondary analysis of previously nerveless qualitative data was performed. This is ethically sound as secondary analysis offers the opportunity to utilise the rich data from the primary study, from another perspective, thus providing some other voice to the perspectives of the participants, who invested considerable time and effort in participating [21].
The study has a number of limitations: only i set of interviews, the 'exit interviews', were analysed for this report, which may mean that upon analysis of the whole data set, patients' perspectives may exist reported slightly differently. This may too mean that the transferability of this data to the general population of heart failure patients may be limited. The sample size (N = 11) is also relatively small, although category saturation had been achieved in the larger data-set.
Implications for hereafter practice
This study emphasises the importance of good communication betwixt patients and their HCPs; respondents valued clinicians who took time to elicit their concerns, and recognised the burden of their symptoms and management. This written report demonstrated that clinicians need to be more than aware of patient co-morbidities and brunt of handling, and the increasing need to liaise with other clinicians to provide care for the whole patient, not just for individual weather. In addition, farther clinician education on recognising a diagnosis of heart failure and beingness able to confidently communicate this to the patient is required, both in primary and secondary care.
Conclusions
The results from this study highlight the importance of education both for current health professionals and aspiring medical students on the value of communication, with patients and other members of the multidisciplinary team. Specifically, lessons can be learned on how to manage patients with multiple co-morbidities and to communicate those management plans both with the other wellness professionals involved with their care and to the patient themselves. Effective communication tin influence a patient'due south overall perspective of their illness and to turn a diagnosis of heart failure from something that prompts 'biographical disruption' into something that a patient can accommodate.
References
-
Anon. Definition of chronic disease. 2015. http://www.medicinenet.com/script/main/art.asp?articlekey=33490 Accessed 25 June 2015.
-
Coffin Thou. Chronic disease as biographical disruption. Sociol Health Illn. 1982;four(2):167–fourscore.
-
Bury Thou. The sociology of chronic illness: a review of enquiry and prospects. Sociol Health Illn. 1991;13(iv):451–68.
-
Stewart S, MacIntyre Thou, Capewell Due south, McMurray JJV. Heart failure and the aging population: an increasing brunt in the 21st century? Heart. 2003;89:49–53.
-
Pattenden JF, Roberts H, Lewin RJP. Living with centre failure; patient and carers perspectives. Eur J Cardiovasc Nurs. 2007;half-dozen:237–79.
-
Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Scwartz JS. Transitional intendance of older adults hospitalized with heart failure: a randomized command trial. J Am Geriatr Soc. 2004;52(v):675–82.
-
Kendall E, Ehrlich C, Sunderland Northward, Muenchberger H, Rushton C. Self-managing versus self-management: reinvigorating the sociopolitical dimensions of self-management. Chronic Disease. 2010;seven(1):87–98.
-
Morris RL, Sanders C, Kennedy AP, Rogers A. Shifting priorities in multimorbidity: a longitudinal qualitative study of patient's prioritization of multiple weather. Chronic Illn. 2011;7(2):147–61.
-
Rolland JS. Family disease paradegms: evolution and significance. Fam Syst Med. 1987;five(iv):482–502.
-
Arestedt L, Benzein Due east, Persson C. Families living with chronic illness: behavior near disease, family, and health care. J Fam Nurs. 2015;21(2):206–31.
-
du Vaure B, et al. Potential workload in applying clinical exercise guidelines for patients with chronic conditions and multimorbidity: a systematic analysis. BMJ Open. 2016;half-dozen:e010119.
-
Ridd Grand, Shaw A, Lewis G, Salisbury C. The patient-doctor relationship: a synthesis of qualitative literature of patients' perspectives. Br J Gen Pract. 2009;59(561):e116–33.
-
Fong Ha J, et al. Doctor-patient communication: a review. Ochsner J. 2010;ten:38–43.
-
Goold SD, Lipkin M. The md-patient relationship: challenges, opportunities and strategies. J Gen Intern Med. 1999;fourteen(i):S26–33.
-
Cocksedge S, Greenfield R, Nugent GK, Chew-Graham CA. Belongings relationships in main care: a qualitative exploration of doctors' and patients' perceptions. Brit J Gen Pract. 2011;61:e484–91.
-
Freeman G, Hughes Grand. The Kings Fund: Continuity of care and the patient experience. The Kings Fund; 2010. world wide web.kingsfund.org.u.k./sites/files/kf/field/field_document/continuity-intendance-patient-feel-gp-inquiry-research-newspaper-mar11.pdf. Accessed 13 Apr 2016.
-
Fairhurst K, May C. Knowing patients and knowledge almost patients: evidence of modes of reasoning in the consultation? Fam Pract. 2001;18(five):501–five.
-
Cheraghi-sohi S, Bower P, Kennedy A, Morden A, Rogers A, Richardson J, Sanders T, Stevenson F, Ong BN. Patient priorities in osteoarthritis and comorbid conditions: a secondary analysis of qualitative data. Arthritis Care Res. 2013;65(6):920–vii.
-
MacKenzie E, Smith A, Angus N, Menzies Due south, Brulisauer F, Leslie SJ. Mixed-method exploratory study of full general practitioner and nurse perceptions of a new customs based nurse-led heart failure service. Rural Remote Health. 2010;10:1510.
-
Simmonds R, Glogowska Thou, McLachlan S, Cramer H, Sanders T, Johnson R, Kadam U, Lasserson D, Purdy S. Unplanned admissions and the organisational management of middle failure: a multicentre ethnographic, qualitative study. BMJ Open. 2015;5(e):007522.
-
Heaton J. Secondary analysis of qualitative information: an overview. Hist Soc Res. 2008;33(iii):33–45.
-
Chew-Graham CA, Kovandzic Grand, Gask L, Burroughs H, Clarke P, Sanderson H, Dowrick C. Why may older people with depression not present in principal care? Messages from secondary analysis of qualitative data. Health Soc Care Community. 2012;20(ane):52–60.
-
Gwaltney CJ, Slagle AF, Martin M, Ariely R, Brede Y. Hearing the voice of the centre failure patient: fundamental experiences identified in qualitative interviews. Br J Cardiol. 2012;19:25.
-
Williams SJ. Chronic illness equally biographical disruption or biographical disruption as chronic disease? Reflections on a core concept. Sociol Wellness Illn. 2000;22(ane):40–67.
-
Glogowska G, Simmonds R, McLachlan S, Cramer H, Sanders T, Johnson R, Kadam UT, Lasserson DS, Purdy S. "Sometimes we can't gear up things": a qualitative report of healthcare professionals' perceptions of end of life treat patients with eye failure. BMC Palliat Care. 2016;15:3.
-
Glogowska M, Simmonds R, McLachlan S, Cramer H, Sanders T, Johnson R, Kadam UT, Lasserson DS, Purdy Southward. Managing patients with heart failure: a qualitative study of multidisciplinary squad with specialist eye failure nurses. Ann Fam Med. 2015;13(5):466–71.
Acknowledgements
This paper presents independent research funded past the National Constitute for Health Research School for Main Care Research (NIHR SPCR). The views expressed are those of the author(s) and non necessarily those of the NIHR, the NHS or the Department of Health.
TS was supported in the training/submission of this newspaper by the Translating Cognition into Action Theme of the National Institute for Health Research Collaboration for Leadership in Applied Health Enquiry and Intendance Yorkshire and Humber (NIHR CLAHRC YH). http://world wide web.clahrc-yh.nihr.ac.united kingdom. (The views and opinions expressed are those of the authors and non necessarily those of the NHS, the NIHR or the Department of Health.)
CCG is part funded by the Collaboration for Leadership in Practical Health Enquiry and Care, Due west Midlands.
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Authors' contributions
MF led the secondary analysis and drafted the manuscript. SMc conducted original interviews in the HoldFAST written report, worked on the main analysis of the HoldFAST data-set, supported MF in conducting the secondary assay and commented on drafts of this manuscript. SP conceived of the written report, was Primary Investigator on the HoldFAST written report, and contributed to the writing of this manuscript. TS led design of the qualitative study, worked on primary assay of the HoldFAST data and commented on drafts of this manuscript. United kingdom of great britain and northern ireland commented on drafts of this manuscript. CC-M supported MF in conducting the secondary assay and supported the writing of this manuscript. All authors read and approved the final manuscript.
Competing interests
The authors declare that they have no competing interests.
Ethics blessing and consent to participate
Ethical approval for the HoldFAST study was granted by NRES Committee South West- Frenchay, Bristol, and local approvals were obtained from Staffordshire Cluster of PCTs Research Management and Governance Office, and the Research & Evolution Department of University Hospital of North Staffordshire NHS Trust.
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Fry, Grand., McLachlan, S., Purdy, S. et al. The implications of living with heart failure; the touch on everyday life, family support, co-morbidities and access to healthcare: a secondary qualitative analysis. BMC Fam Pract 17, 139 (2016). https://doi.org/10.1186/s12875-016-0537-5
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DOI : https://doi.org/ten.1186/s12875-016-0537-five
Keywords
- Eye Failure
- Healthcare Professional person
- Exit Interview
- Manage Centre Failure
- Previous Qualitative Study
Source: https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-016-0537-5
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