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Views of Patients With Heart Failure on Their Value-Based Self-care Decisions: A Qualitative Study
Journal of Cardiovascular Nursing ( IF 2 ) Pub Date : 2020-11-01 , DOI: 10.1097/jcn.0000000000000733
Mehri Karimi-Dehkordi 1 , Alexander M Clark
Affiliation  

Background 

Self-care adherence remains low in patients with heart failure (HF); little is known about the influence of patients' values on self-care decisions and behaviors.

Objectives 

The aim of this study was to explore how participants living with HF perceive their values and how those values are reportedly expressed in self-care decision making.

Methods 

The Interpretative Phenomenological Analysis approach was used. Semistructured interviews were conducted with 12 patients 60 years or older; with New York Heart Association class II and III HF; and able to speak, read, and understand English. Participants recruited via convenience sampling (January–December 2016) from 2 urban sites in Western Canada.

Results 

Values were reported to pivotally influence HF self-care decisions and behaviors. Overarching themes addressed aspects of values and decision making: notably, directness and complexity. Two main types of values, functional and emotional values, were involved in both adherent and nonadherent decisions. Values were often in flux, with the pursuit of these values being frequently in conflict with physical ability and changing over time.

Conclusion 

Two types of values serve influence self-care decisions and adherence. As HF and its self-care prevent patients from pursuing their prioritized values, patients are often nonadherent. Thus, patients with HF should be supported to find alternative ways to enact their values.



中文翻译:

心力衰竭患者对基于价值的自我保健决策的看法:一项定性研究

背景 

心力衰竭(HF)患者的自我护理依从性仍然很低;关于患者价值观自我护理决策和行为的影响知之甚少。

目标 

这项研究的目的是探索患有 HF 的参与者如何看待他们的价值观,以及这些价值观在自我保健 决策中如何表达。

方法 

使用了解释性现象学分析方法。对 12 名 60 岁或以上的患者进行了半结构化访谈;纽约心脏协会 II 级和 III 级 HF;并且能够说、读和理解英语。通过便利抽样(2016 年 1 月至 12 月)从加拿大西部的 2 个城市地点招募参与者。

结果 

据报道,价值观对 HF自我护理决定和行为有关键影响。总体主题涉及价值观和决策的各个方面:特别是直接性和复杂性。两种主要类型的价值观,功能性价值观和情感价值观,都参与了依从性和非依从性决策。价值观往往在不断变化,对这些价值观的追求经常与身体能力发生冲突并随着时间的推移而变化。

结论 

两种类型的价值观会影响自我保健的决定和依从性。由于 HF 及其自我护理阻止患者追求他们的优先价值观,因此患者通常不依从。因此,应该支持 HF 患者寻找替代方法来制定他们的价值观。

更新日期:2020-10-30
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