Congestive heart failure self-management among US veterans: The role of personal and professional advocates

Patient Educ Couns. 2014 Jun;95(3):371-7. doi: 10.1016/j.pec.2014.03.002. Epub 2014 Mar 13.

Abstract

Objective: Understand patients' experiences with primary care services for congestive heart failure (CHF) and explore the relationship between health services and self-management.

Methods: We conducted semi-structured interviews with thirty-nine patients with CHF receiving care at one Veterans Affairs Medical Center (VA). We analyzed data using thematic content analysis.

Results: Participants acknowledged the importance of ongoing engagement in the plan of care for CHF. They attributed success in this effort to be greatly influenced by personal advocates. The advocates included both members of the healthcare team with whom they had a continuity relationship and friends or family members who assisted on a daily basis. Participants also identified psychological symptoms as a major barrier to carrying out self-care.

Conclusion: Patients identify relationships with health care workers, help from family and friends, and mental health problems as major influences on the ability to manage their CHF.

Practice implications: Efforts to optimize CHF self-management should attend to health system and psychosocial barriers to care.

Keywords: Heart failure; Primary care redesign; Qualitative research; Self-management; US; Veterans.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Disease Management
  • Family
  • Female
  • Health Personnel
  • Heart Failure / psychology
  • Heart Failure / therapy*
  • Hospitals, Veterans
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / statistics & numerical data
  • Patient Advocacy*
  • Primary Health Care
  • Qualitative Research
  • Self Care / methods*
  • United States
  • Veterans / statistics & numerical data*