Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Western Sydney University, Sydney, NSW, Australia.
Scand J Caring Sci. 2020 Dec;34(4):1094-1101. doi: 10.1111/scs.12820. Epub 2020 Jan 27.
For people managing chronic illness, such as heart failure, adequate health literacy is crucial to understand the complex information that underpins self-care, yet evidence suggests poor understanding in this patient population. To better understand patients' heart failure comprehension and why knowledge gaps may exist, this study sought to explore perceptions of patient-provider communication and ascertain unmet educational needs and preferences.
Semi-structured in-depth interviews were conducted with 15 symptomatic inpatients with heart failure. Data collection and analysis occurred simultaneously until saturation was reached. Transcripts were analysed using thematic analysis.
Participants relied heavily on providers for HF information and support, expressed numerous unmet educational needs and had mixed feelings about quality of communication. Participants expressed the need for credible, tailored heart failure information that accounted for comorbid conditions and preference for face-to-face information delivery. Knowledge gaps included heart failure pharmacotherapy, symptom appraisal and management, cause and chronicity of heart failure, and a specific action plan for heart failure symptom exacerbation. Barriers to effective patient-provider communication included providers using complex medical terminology, lack of adequately detailed information, relationships that did not foster open communication and participants' memory problems.
Gaps in knowledge and poor communication may indicate inadequate availability of multidisciplinary heart failure management programmes and/or fidelity to guideline recommendations.
Evaluating heart failure management programmes is important to ensure consistent delivery of best-practice education and care. Nurses play a key role in the delivery of patient-focused health information.
对于患有慢性疾病（如心力衰竭）的患者来说，具备足够的健康素养对于理解自我护理所依据的复杂信息至关重要，但有证据表明，这一患者群体的理解能力较差。为了更好地了解患者对心力衰竭的理解程度，以及为什么可能存在知识差距，本研究旨在探讨患者与医务人员之间的沟通看法，并确定未满足的教育需求和偏好。
对 15 名有症状的心力衰竭住院患者进行了半结构化深入访谈。在达到饱和之前，同时进行数据收集和分析。使用主题分析对转录本进行分析。
参与者严重依赖医务人员获取 HF 信息和支持，表达了许多未满足的教育需求，对沟通质量的看法喜忧参半。参与者表示需要可信且量身定制的心力衰竭信息，其中应考虑到合并症，并希望以面对面的方式提供信息。知识差距包括心力衰竭药物治疗、症状评估和管理、心力衰竭的病因和慢性、以及心力衰竭症状恶化的具体行动计划。有效医患沟通的障碍包括医务人员使用复杂的医学术语、信息缺乏足够的详细信息、没有促进开放沟通的关系以及参与者的记忆问题。
知识差距和沟通不畅可能表明多学科心力衰竭管理方案的可用性不足，或者对指南建议的遵循程度不够。
评估心力衰竭管理方案对于确保一致提供最佳实践教育和护理非常重要。护士在提供以患者为中心的健康信息方面发挥着关键作用。
