Part I: Heart failure home management: Patients, multidisciplinary health care professionals and family caregivers' perspectives

2012 ◽  
Vol 25 (4) ◽  
pp. 239-245 ◽  
Author(s):  
Ubolrat Piamjariyakul ◽  
Carol E. Smith ◽  
Marilyn Werkowitch ◽  
Andrea Elyachar
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Home Management

scholarly journals Health-care Workforce Training to Effectively Support Family Caregivers of Seniors in Care

2020 ◽  
Vol 23 (2) ◽  
pp. 160-171
Author(s):  
Rachel Fisher ◽  
Jasneet Parmar ◽  
Wendy Duggleby ◽  
Peter George J. Tian ◽  
Wonita Janzen ◽  
...  
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Well Being ◽  
Workforce Training ◽  
Community Dwelling ◽  
Canadian Health Care System ◽  
Care Services ◽  
Qualitative Thematic Analysis

Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.

scholarly journals Design of a Consumer Mobile Health App for Heart Failure: Findings From the Nurse-Led Co-Design of Care4myHeart (Preprint)

2019 ◽  
Author(s):  
Leanna Woods ◽  
Jed Duff ◽  
Erin Roehrer ◽  
Kim Walker ◽  
Elizabeth Cummings
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Family Caregivers ◽  
Design Process ◽  
Mobile Health ◽  
Design Thinking ◽  
Graphical Representation ◽  
Community Dwelling ◽  
Self Management ◽  
Data Feedback

BACKGROUND Consumer health care technology shows potential to improve outcomes for community-dwelling persons with chronic conditions, yet health app quality varies considerably. In partnership with patients and family caregivers, hospital clinicians developed Care4myHeart, a mobile health (mHealth) app for heart failure (HF) self-management. OBJECTIVE The aim of this paper was to report the outcomes of the nurse-led design process in the form of the features and functions of the developed app, Care4myHeart. METHODS Seven patients, four family caregivers, and seven multidisciplinary hospital clinicians collaborated in a design thinking process of innovation. The co-design process, involving interviews, design workshops, and prototype feedback sessions, incorporated the lived experience of stakeholders and evidence-based literature in a design that would be relevant and developed with rigor. RESULTS The home screen displays the priority HF self-management components with a reminder summary, general information on the condition, and a settings tab. The health management section allows patients to list health care team member’s contact details, schedule medical appointments, and store documents. The My Plan section contains nine important self-management components with a combination of information and advice pages, graphical representation of patient data, feedback, and more. The greatest strength of the co-design process to achieve the design outcomes was the involvement of local patients, family caregivers, and clinicians. Moreover, incorporating the literature, guidelines, and current practices into the design strengthened the relevance of the app to the health care context. However, the strength of context specificity is also a limitation to portability, and the final design is limited to the stakeholders involved in its development. CONCLUSIONS We recommend health app development teams strategically incorporate relevant stakeholders and literature to design mHealth solutions that are rigorously designed from a solid evidence base and are relevant to those who will use or recommend their use.

scholarly journals Adult cardiovascular surgery and the coronavirus disease 2019 (COVID-19) pandemic: the Italian experience

2020 ◽  
Vol 31 (6) ◽  
pp. 755-762
Author(s):  
Francesco Donatelli ◽  
Antonio Miceli ◽  
Mattia Glauber ◽  
Silvia Cirri ◽  
Ciro Maiello ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Professionals ◽  
Cardiovascular Surgery ◽  
Adverse Outcomes ◽  
Local Health ◽  
Heart Team ◽  
Italian Experience ◽  
Refractory Heart Failure ◽  
Increased Risk

Abstract The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected all health care professionals. The outbreak required a thorough reorganization of the Italian regional local health care system to preserve resources such as ventilators, beds in intensive care units and surgical and anaesthesiological staff. Levels of priority were created, together with a rigorous triage procedure for patients with COVID-19, which led to postponement of all elective procedures. Urgent cases were discussed with the local heart team and percutaneous approaches were selected as the first treatment option to reduce hospital stay. COVID-19 and COVID-19-free pathways were created, including adequate preparation of the operating room, management of anaesthesiological procedures, transportation of patients and disinfection. It was determined that patients with chronic diseases were at increased risk of adverse outcomes. Systemic inflammation, cytokine storm and hypercoagulability associated with COVID-19 increased the risk of heart failure and cardiac death. In this regard, the early use of extracorporeal membrane oxygenation could be life-saving in patients with severe forms of acute respiratory distress syndrome or refractory heart failure. The goal of this paper was to report the Italian experience during the COVID-19 pandemic in the setting of cardiovascular surgery.

scholarly journals Health Care Professionals’ Perceptions of Home Telemonitoring in Heart Failure Care: Cross-Sectional Survey

10.2196/10362 ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e10362 ◽  
Author(s):  
Ina Thon Aamodt ◽  
Edita Lycholip ◽  
Jelena Celutkiene ◽  
Anna Strömberg ◽  
Dan Atar ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Professionals ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Heart Failure Care ◽  
Home Telemonitoring

scholarly journals Heart failure: A challenging syndrome for health care professionals

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Ekaterini Lambrinou ◽  
Andreas Protopapas ◽  
Fotini Kalogirou
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Professionals

Health Care Professionals’ Perspectives of the Experiences of Family Caregivers During In-Patient Cancer Care

2014 ◽  
Vol 20 (4) ◽  
pp. 462-486 ◽  
Author(s):  
Mirjam Ekstedt ◽  
Una Stenberg ◽  
Mariann Olsson ◽  
Cornelia M. Ruland
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
Cancer Care

scholarly journals Family and health-care professionals managing medicines for patients with serious and terminal illness at home: a qualitative study

2021 ◽  
Vol 9 (14) ◽  
pp. 1-162
Author(s):  
Kristian Pollock ◽  
Eleanor Wilson ◽  
Glenys Caswell ◽  
Asam Latif ◽  
Alan Caswell ◽  
...  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Family Caregivers ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Terminal Illness ◽  
Life Care ◽  
Medicines Management ◽  
At Home

Background More effective ways of managing symptoms of chronic and terminal illness enable patients to be cared for, and to die, at home. This requires patients and family caregivers to manage complex medicines regimens, including powerful painkillers that can have serious side effects. Little is known about how patients and family caregivers manage the physical and emotional work of managing medicines in the home or the support that they receive from health-care professionals and services. Objective To investigate how patients with serious and terminal illness, their family caregivers and the health-care professionals manage complex medication regimens and routines of care in the domestic setting. Design A qualitative study involving (1) semistructured interviews and group discussions with 40 health-care professionals and 21 bereaved family caregivers, (2) 20 patient case studies with up to 4 months’ follow-up and (3) two end-of-project stakeholder workshops. Setting This took place in Nottinghamshire and Leicestershire, UK. Results As patients’ health deteriorated, family caregivers assumed the role of a care co-ordinator, undertaking the everyday work of organising and collecting prescriptions and storing and administering medicines around other care tasks and daily routines. Participants described the difficulties of navigating a complex and fragmented system and the need to remain vigilant about medicines prescribed, especially when changes were made by different professionals. Access to support, resilience and coping capacity are mediated through the resources available to patients, through the relationships that they have with people in their personal and professional networks, and, beyond that, through the wider connections – or disconnections – that these links have with others. Health-care professionals often lacked understanding of the practical and emotional challenges involved. All participants experienced difficulties in communication and organisation within a health-care system that they felt was complicated and poorly co-ordinated. Having a key health professional to support and guide patients and family caregivers through the system was important to a good experience of care. Limitations The study achieved diversity in the recruitment of patients, with different characteristics relating to the type of illness and socioeconomic circumstances. However, recruitment of participants from ethnically diverse and disadvantaged or hard-to-reach populations was particularly challenging, and we were unable to include as many participants from these groups as had been originally planned. Conclusions The study identified two key and inter-related areas in which patient and family caregiver experience of managing medicines at home in end-of-life care could be improved: (1) reducing work and responsibility for medicines management and (2) improving co-ordination and communication in health care. It is important to be mindful of the need for transparency and open discussion about the extent to which patients and family caregivers can and should be co-opted as proto-professionals in the technically and emotionally demanding tasks of managing medicines at the end of life. Future work Priorities for future research include investigating how allocated key professionals could integrate and co-ordinate care and optimise medicines management; the role of domiciliary home care workers in supporting medicines management in end-of-life care; patient and family perspectives and understanding of anticipatory prescribing and their preferences for involvement in decision-making; the experience of medicines management in terminal illness among minority, disadvantaged and hard-to-reach patient groups; and barriers to and facilitators of increased involvement of community pharmacists in palliative and end-of-life care. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 14. See the NIHR Journals Library website for further project information.

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