Mejorando el apoyo para pacientes con ICC: una RS para comprender la perspectiva de pacientes en su cuidado – Journal of Advanced Nursing

Improving support for heart failure patients: a systematic review to understand patients’ perspectives on self-care

Abstract

Aims

This systematic review aimed to generate patient-focussed recommendations to enhance support of heart failure self-care by examining patients’ experiences, perspectives and self-care behaviours.

Background

Despite increased recognition of the importance of heart failure self-care, patients’ knowledge and practices around this self-care and interventions to improve it are inconsistent. Consequently, current guidelines focus on what the domains of heart failure self-care are, more so than the ways to improve this care.

Design

Systematic review and qualitative interpretive synthesis.

Data sources

A systematic, comprehensive and detailed search of 11 databases was conducted until March, 2012 for papers published 1995–2012: 37 studies were included (1343 patients, 75 caregivers, 63 health care professionals) that contained a qualitative research component and data on adult patients’ heart failure self-care.

Review methods

This interpretive synthesis used a recognized approach consisting of a multi-stage analytic process; in addition, the included studies underwent quality appraisal.

Results

Findings indicate that while patients could often recall health professionals’ self-care advice, they were unable to integrate this knowledge into daily life. Attempts to manage HF were based on how patients ‘felt’ rather than clinical indicators of worsening symptoms. Self-efficacy and learning from past management experiences facilitated favourable outcomes – these enabled patients and caregivers to adeptly apply self-care strategies into daily activities.

Conclusions

Addressing common but basic knowledge misconceptions regarding the domains of HF self-care is insufficient to increase effective HF self-care; this should be supplemented with strategies with patients and family members to promote self-efficacy, learning and adaptation/application of recommendations to daily life.

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2010 © Foro Latinoamericano Colaborativo en Calidad y Seguridad en Salud

Desarrollado por IECS (Instituto de Efectividad Clínica y Sanitaria)

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