Patient Preferences for the Delivery of Disease Management in Chronic Heart Failure: A Qualitative Study
Journal of Cardiovascular Nursing, 05/10/2012
Whitty JA et al. – The preliminary data suggest that patients value aspects of a program beyond those directly related to health outcomes. They also recognize a need for flexibility in program delivery, with potential preferences for home– or clinic–based programs depending largely on individual patient circumstances. More definitive studies are required to explore how best to cater for individual preferences while optimizing health outcomes.Methods
- Semistructured interviews with a purposive sample of 12 CHF patients.
- Participants had a mean age of 61 (SD, 17) years, 3 were female, and the majority was of white background.
- Most were assessed as either functional New York Heart Association class III (n = 3) or IV (n = 6).
- Home– and clinic–based CHF–MPs were preferred by 5 and 7 participants, respectively.
- Key themes around patient preferences related to practical aspects of program delivery and social and peer support, as well as health–related benefits that translate to traditional outcomes in program evaluations.
- Participants identified transport, cost, and ill health as barriers to attending a clinic–based program.
- However, they also highlighted benefits (eg, the ability to share experiences with other patients) that may be difficult to provide with a home–based service unless specifically organized.