Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
Health Services Management Centre, University of Birmingham, Birmingham, UK.
BMC Cardiovasc Disord. 2019 Apr 23;19(1):92. doi: 10.1186/s12872-019-1075-6.
Heart failure (HF) is a common clinical syndrome, particularly in older people, and symptoms can develop gradually. The aim of this study was to explore the role of informal carers in the HF diagnostic process.
Secondary analysis of qualitative interviews with 16 participants with a new diagnosis of HF. Original interviews were conducted in the participant's home, with carers present in some cases. Interview transcripts were re-analysed using the Framework Method for themes pertaining to informal carers and how they were involved in the diagnostic process.
Informal carers often noticed symptoms, such as breathlessness, before participants. In some cases, carers colluded with participants in normalising symptoms but over time, when symptoms failed to resolve or got worse, they encouraged participants to seek medical help. Adult children of participants commonly initiated help-seeking behaviour. During the diagnostic process, carers coordinated participants' healthcare through advocacy and organisation. Carers were keen to be informed about the diagnosis, but both participants and carers struggled to understand some aspects of the term 'heart failure'.
Carers play a crucial role in HF diagnosis, particularly in initiating contact with healthcare services, and should be empowered to encourage people with HF symptoms to seek medical help. Improving public awareness of HF could mean informal carers are more likely to notice symptoms. The important role of carers in supporting the patient's route to diagnosis should be incorporated into future care pathways and explored in further research.
心力衰竭（HF）是一种常见的临床综合征，尤其在老年人中较为常见，且症状可能逐渐出现。本研究旨在探讨非专业护理人员在 HF 诊断过程中的作用。
对 16 名新诊断为 HF 的患者进行定性访谈的二次分析。原始访谈在患者家中进行，在某些情况下护理人员在场。使用框架方法对与非专业护理人员相关的主题以及他们如何参与诊断过程进行重新分析。
非专业护理人员通常比患者更早注意到呼吸困难等症状。在某些情况下，护理人员与患者串通使症状正常化，但随着时间的推移，当症状无法缓解或恶化时，他们鼓励患者寻求医疗帮助。患者的成年子女通常会主动寻求帮助。在诊断过程中，护理人员通过倡导和组织来协调患者的医疗保健。护理人员渴望了解诊断情况，但患者和护理人员都难以理解“心力衰竭”这个术语的某些方面。
护理人员在 HF 诊断中起着至关重要的作用，特别是在与医疗保健服务联系方面，应赋予他们鼓励有 HF 症状的人寻求医疗帮助的权力。提高公众对 HF 的认识意味着非专业护理人员更有可能注意到症状。应将护理人员在支持患者诊断过程中的重要作用纳入未来的护理路径，并在进一步的研究中进行探讨。
