TY - JOUR
T1 - Understanding help-seeking decisions in people with heart failure
T2 - A qualitative systematic review
AU - Clark, Alexander M.
AU - Savard, Lori A.
AU - Spaling, Melisa A.
AU - Heath, Stephanie
AU - Duncan, Amanda S.
AU - Spiers, Judith A.
N1 - Funding Information:
AMC is supported by a career awards from Alberta Innovates Health Solutions and the Canadian Institutes for Health Research . The review was funded in part by a Small Faculties Grant from the University of Alberta .
PY - 2012/12
Y1 - 2012/12
N2 - Objective: To understand the process of help-seeking among heart failure patients from the perspectives of patients, caregivers and health professionals. Design: Systematic review using qualitative meta-synthesis. Methods: A systematic search (20th May 2011) was conducted to identify studies published in English as full papers ≥1995 reporting primary qualitative data with extractable heart failure-specific data or themes related to help-seeking in patients, caregivers or health professionals. Databases searched were: CINAHL, Medline, PsycInfo, Social Science Citation Index, Embase, Social policy/Practice, SocIndex, Ageline, Health Source Nursing, Scopus; additionally, we consulted with experts and manually searched references. Results: 58 studies (990 patients; 274 female, 527 male, 189 sex not described; 229 caregivers, 79 health professionals) were included. Heart failure help-seeking was embedded in daily experiences of heart failure but ongoing symptoms were confusing, ambiguous and disruptive; little support was available from professionals to interpret the presence and significance of fluctuations in symptoms for help-seeking. Other significant barriers to help-seeking were: avoidance-based coping, fear of hospitals and misplaced reluctance to be burdensome. Help-seeking was facilitated by good involvement and frank communication between patients, caregivers and health professionals and the presence of a sense of elevated personal risk. Conclusion: Health services should harness primary care providers and support patients and caregivers to prioritize development of objective symptom monitoring skills, recognize and personally assimilate the elevated risks of heart failure and help-seeking delays and discourage avoidance-based coping and unwarranted concerns that downplay the significance of heart failure and urgency to address symptoms.
AB - Objective: To understand the process of help-seeking among heart failure patients from the perspectives of patients, caregivers and health professionals. Design: Systematic review using qualitative meta-synthesis. Methods: A systematic search (20th May 2011) was conducted to identify studies published in English as full papers ≥1995 reporting primary qualitative data with extractable heart failure-specific data or themes related to help-seeking in patients, caregivers or health professionals. Databases searched were: CINAHL, Medline, PsycInfo, Social Science Citation Index, Embase, Social policy/Practice, SocIndex, Ageline, Health Source Nursing, Scopus; additionally, we consulted with experts and manually searched references. Results: 58 studies (990 patients; 274 female, 527 male, 189 sex not described; 229 caregivers, 79 health professionals) were included. Heart failure help-seeking was embedded in daily experiences of heart failure but ongoing symptoms were confusing, ambiguous and disruptive; little support was available from professionals to interpret the presence and significance of fluctuations in symptoms for help-seeking. Other significant barriers to help-seeking were: avoidance-based coping, fear of hospitals and misplaced reluctance to be burdensome. Help-seeking was facilitated by good involvement and frank communication between patients, caregivers and health professionals and the presence of a sense of elevated personal risk. Conclusion: Health services should harness primary care providers and support patients and caregivers to prioritize development of objective symptom monitoring skills, recognize and personally assimilate the elevated risks of heart failure and help-seeking delays and discourage avoidance-based coping and unwarranted concerns that downplay the significance of heart failure and urgency to address symptoms.
KW - Chronic disease management
KW - Heart failure
KW - Help-seeking
KW - Self-care
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84869884538&partnerID=8YFLogxK
U2 - 10.1016/j.ijnurstu.2012.05.010
DO - 10.1016/j.ijnurstu.2012.05.010
M3 - Review article
C2 - 22721677
AN - SCOPUS:84869884538
SN - 0020-7489
VL - 49
SP - 1582
EP - 1597
JO - International Journal of Nursing Studies
JF - International Journal of Nursing Studies
IS - 12
ER -