Gostoli Sara, Bernardini Francesco, Subach Regina, Engelmann Petra, Jaarsma Tiny, Andréasson Frida, Rasmussen Sanne, Thilsing Trine, Eilerskov Natasja, Bordoni Barbara, Della Riva Diego, Urbinati Stefano, Kohlmann Sebastian, Rafanelli Chiara
Department of Psychology "Renzo Canestrari", University of Bologna, Bologna, Italy.
Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Front Cardiovasc Med. 2024 Mar 13;11:1332356. doi: 10.3389/fcvm.2024.1332356. eCollection 2024.
Few studies explored healthcare needs of elderly heart failure (HF) patients with comorbidities in view of a personalized intervention conducted by Care Managers (CM) in the framework of Blended Collaborative Care (BCC). The aims of the present study were to: (1) identify perceived healthcare needs/preferences in elderly patients with HF prior to a CM intervention; (2) investigate possible associations between healthcare needs/preferences, sociodemographic variables (age; sex) and number of comorbidities.
Patients aged 65 years or more affected by HF with at least 2 medical comorbidities were enrolled in the study. They were assessed by structured interviewing with colored cue cards that represented six main topics including education, individual tailoring of treatment, monitoring, support, coordination, and communication, related to healthcare needs and preferences.
Thirty-three patients (Italy = 21, Denmark = 7, Germany = 5; mean age = 75.2 ± 7.7 years; males 63.6%) were enrolled from June 2021 to February 2022. Major identified needs included: HF information (education), patients' involvement in treatment-related management (individual tailoring of treatment), regular checks of HF symptoms (monitoring), general practitioner update by a CM about progression of symptoms and health behaviors (coordination), and telephone contacts with the CM (communication). Regarding communication modalities with a CM, males preferred phone calls (= 6.291, = 0.043) and mobile messaging services (= 9.647, = 0.008), whereas females preferred in-person meetings and a patient dashboard. No differences in needs and preferences according to age and number of comorbidities were found.
The findings highlight specific healthcare needs and preferences in older HF multimorbid patients, allowing a more personalized intervention delivered by CM in the framework of BCC.
鉴于护理经理（CM）在混合协作护理（BCC）框架下进行的个性化干预，很少有研究探讨患有合并症的老年心力衰竭（HF）患者的医疗保健需求。本研究的目的是：（1）在CM干预之前确定老年HF患者感知到的医疗保健需求/偏好；（2）调查医疗保健需求/偏好、社会人口统计学变量（年龄、性别）和合并症数量之间可能存在的关联。
年龄在65岁及以上、患有HF且至少有2种合并症的患者纳入本研究。通过使用彩色提示卡进行结构化访谈对他们进行评估，这些提示卡代表六个主要主题，包括教育、治疗的个性化定制、监测、支持、协调和沟通，与医疗保健需求和偏好相关。
2021年6月至2022年2月共纳入33例患者（意大利=21例，丹麦=7例，德国=5例；平均年龄=75.2±7.7岁；男性占63.6%）。确定的主要需求包括：HF信息（教育）、患者参与治疗相关管理（治疗的个性化定制）、定期检查HF症状（监测）、CM向全科医生通报症状进展和健康行为（协调）以及与CM进行电话联系（沟通）。关于与CM的沟通方式，男性更喜欢打电话（=6.291，=0.043）和移动消息服务（=9.647，=0.008），而女性更喜欢面对面会议和患者仪表板。未发现根据年龄和合并症数量在需求和偏好方面存在差异。
研究结果突出了老年HF多合并症患者特定的医疗保健需求和偏好，使得CM在BCC框架下能够提供更个性化的干预。
