Understanding Patients’ Experiences of Treatment Burden in Chronic Heart Failure Using Normalization Process Theory
TLDR
The findings suggest that NPT is a theoretical framework that facilitates understanding of experiences of health care work at the individual, as well as the organizational, level and lay the foundation for a new target for treatment and quality improvement efforts toward patient-centered care.Abstract:
PURPOSE Our goal was to assess the burden associated with treatment among patients living with chronic heart failure and to determine whether Normalization Process Theory (NPT) is a useful framework to help describe the components of treatment burden in these patients. METHODS We performed a secondary analysis of qualitative interview data, using framework analysis, informed by NPT, to determine the components of patient “work.” Participants were 47 patients with chronic heart failure managed in primary care in the United Kingdom who had participated in an earlier qualitative study about living with this condition. We identified and examined data that fell outside of the coding frame to determine if important concepts or ideas were being missed by using the chosen theoretical framework. RESULTS We were able to identify and describe components of treatment burden as distinct from illness burden using the framework. Treatment burden in chronic heart failure includes the work of developing an understanding of treatments, interacting with others to organize care, attending appointments, taking medications, enacting lifestyle measures, and appraising treatments. Factors that patients reported as increasing treatment burden included too many medications and appointments, barriers to accessing services, fragmented and poorly organized care, lack of continuity, and inadequate communication between health professionals. Patient “work” that fell outside of the coding frame was exclusively emotional or spiritual in nature. CONCLUSIONS We identified core components of treatment burden as reported by patients with chronic heart failure. The findings suggest that NPT is a theoretical framework that facilitates understanding of experiences of health care work at the individual, as well as the organizational, level. Although further exploration and patient endorsement are necessary, our findings lay the foundation for a new target for treatment and quality improvement efforts toward patient-centered care.read more
Citations
More filters
Journal ArticleDOI
Barriers and facilitators of micronutrient supplementation among non-pregnant women of reproductive age in Johannesburg, South Africa
Takana M Silubonde,Catherine E. Draper,Jeannine Baumgartner,Lisa J. Ware,Cornelius M. Smuts,Shane A. Norris +5 more
TL;DR: In this article , a qualitative study was embedded in a preconception MMS intervention trial of non-pregnant women of reproductive age (WRA) and was conducted in two phases.
Journal ArticleDOI
Sustainable and effective methods to increase long‐acting reversible contraception uptake from the ACCORd general practice trial
Angela Taft,Cathy J. Watson,Edwina McCarthy,Kirsten I. Black,Jayne Lucke,Kevin McGeechan,Marion Haas,Kathleen McNamee,Jeffrey F. Peipert,Danielle Mazza +9 more
TL;DR: The Australian Contraceptive ChOice pRoject (ACCORd) successfully tested a complex intervention for LARC uptake and the critical elements of this intervention were explored to increase LARCS uptake.
Journal ArticleDOI
Editorial: Supportive care for people living with the manifold burden of heart failure.
TL;DR: Benefits in assessing patients’ and families’ means of coping with this life-limiting disease are suggested, elucidating and supporting their psychosocial needs, facilitating approaches to advance care planning and end of life care to achieve outcomes consistent with their choices and values.
Journal ArticleDOI
Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial
Melanie A. Holden,Michael J. Callaghan,David T. Felson,Fraser Birrell,Elaine Nicholls,Sue Jowett,Jesse Kigozi,John McBeth,Belinda Borrelli,Clare Jinks,Nadine E. Foster,Krysia Dziedzic,Christian D Mallen,Carol Ingram,Alan Sutton,Sarah A Lawton,Nicola Halliday,Liz Hartshorne,Helen L. Williams,Rachel Browell,Hannah Hudson,Michelle Marshall,Gail Sowden,Dan Herron,Evans Asamane,George Peat +25 more
TL;DR: In this article, the authors evaluated the clinical and cost-effectiveness of adding knee bracing (matched to patients' clinical and radiographic presentation and with adherence support) to a package of advice, written information and exercise instruction.
Journal ArticleDOI
Psychometric Validation of the Living with Chronic Illness Scale in Patients with Chronic Heart Failure.
Leire Ambrosio,David Pérez-Manchón,Gloria Carvajal-Carrascal,Alejandra Fuentes-Ramírez,Neus Caparrós,Manuel Ignacio Ruiz de Ocenda,Eva Timonet,María Victoria Navarta-Sánchez,Carmen Rodriguez-Blazquez +8 more
TL;DR: The Living with Chronic Illness Scale-HF (LW-CI-HF) is the only available tool to evaluate how patients are living with chronic heart failure (HF).
References
More filters
Journal ArticleDOI
Crossing the Quality Chasm: A New Health System for the 21st Century
TL;DR: Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Book
Qualitative Research Practice: A Guide for Social Science Students and Researchers
TL;DR: The Foundations of Qualitative Research as mentioned in this paper The applications of qualitative methods to social research are discussed in detail in the context of qualitative research in the field of social science research, with a focus on the use of qualitative data.
Journal ArticleDOI
Analysing qualitative data
TL;DR: Qualitative research produces large amounts of textual data in the form of transcripts and observational fieldnotes, and the systematic and rigorous preparation and analysis of these data is time consuming and labour intensive.
Journal ArticleDOI
Adherence to long-term therapies: evidence for action.
TL;DR: This report highlights the need for a multi-disciplinary approach to adherence, emphasizes system factors that need to be addressed in successfully implementing adherence-enhancing strategies, and provides illustrative examples of the ways in which professionals have contributed in their own fields of expertise including cardiovascular care among other fields.
Journal ArticleDOI
Adherence to Long-Term Therapies: Evidence for Action:
Sabina De Geest,Eduardo Sabaté +1 more
TL;DR: In this paper, a comprehensive report entitled Adherence to Long-Term Therapies: Evidence for Action w1x was published, focusing on nine chronic conditions and their risk factors.
Related Papers (5)
Implementing, embedding, and integrating practices: An outline of Normalization Process Theory.
Carl May,Tracy Finch +1 more