| Study | Design | Population | Research aim | Comments |
|---|---|---|---|---|
| Aldred 20048 | Semi-structured interviews with pt + carers, taped and transcribed verbatim. Data coded and analysed by two researchers. Four themes most relevant to aims presented. | N=10 CHF pt recently discharged from hospital and one person each that they lived with and nominated a carer. Age: mean 72 (SD 5) Severity NYHA II-IV (6/10 NYHA III) | Explore the impact of heart failure on the lives of older pt and their informal carers. | Part of larger study on palliative needs. Setting: UK, Barnsley. |
| Andersson 201314 | Semi-structured interviews with pt about daily life with CHF, and their experience of information-giving and follow-up. Informed by grounded theory. | N= 4 pt who had been treated in a HF clinic, and were now discharged to primary care. Ages 60, 62, 63, & 84 Severity: Not stated | Investigating whether pt’ need for information, education and knowledge are met to the same extent in the HF clinic and primary care. | Setting: Small town in Sweden. |
| Baudendistal 201529 | Pt interviews with open section and a second more focused part. Content analysis by two researchers independently, then discussed within the research team. | N= 17 pt identified by GPs with CHF with LVEF<35%. Age: mean 72 (SD 12) Severity: Not stated | Explore perspectives of pt with CHF on their treatment across multiple care settings and to what extent these perspectives are represented in current quality indicators. | Part of QUALIPAT heart project, which aims to find patient-centric quality indicators for care. Setting: Academic GP practices, Heidelberg, Germany. |
| Boyd 200447 | Semi-structured interviews with pt with advanced CHF, carers, health and care professionals. Pt interviewed every three months for up to a year. Interviews were followed by focus groups. Concurrent analysis using narrative analysis framework. | N= 20 pt with advanced CHF and their carers (family/informal 27 interviews, professional 30 interviews). Five died during follow-up and family gave bereavement interview. Age: mean 70 (range 57-92) Severity: NYHA IV | Provide a patient-centric account of the changing and evolving needs of people with advanced heart failure, and how services address these. | Part of larger palliative care project. Setting: UK, region unclear |
| Fuat 2005124 | Semi-structured interview with CHF-HCP. Analysis follows “pragmatic variant” grounded theory with a degree of constant comparison. | N= 12 HCP involved in specialist HF services (cardiologists, geriatricians, general physicians and specialist GPs). | Explore reasons for the variations in the diagnosis and management of heart failure and identify barriers to the provision of uniformly high standards of care. | Setting: UK, Durham and Tees SHA |
| Gallacher 2011126 | Qualitative secondary analysis. Use archived interviews with pt collected for related research (unpublished). Analysis used “Normalisation Process”. Two authors designed a coding framework, while a third adjudicated. | N= 47 pt with a CHF diagnosis based on echo, taking ACE-inhibitors and a diuretic, sampled from primary care to mirror demographics of CHF. Age: mean 73 (range 45-88) Severity: Not stated | Identify and understand the components of treatment burden to inform the development of tools to measure this, HF being a condition likely to have high treatment burden and comorbidity. | Setting: UK, not clear where or when. |
| Gastelurrutia 2012127 | Semi-structured interviews with HCP about health problems commonly comorbid with CHF (hyperuricemia, anti-platelet agents, anaemia and diabetes). Analysed using a total sample, open coding, constant comparative approach. | N= 5 internal medicine specialists and cardiologists from a tertiary hospital HF clinic. | Explore experiences in the pharmacological management of common comorbid health problems in heart failure in order to help clinical pharmacists provide real and practical help. | Setting: HF clinic in Spanish hospital. |
| Glogowska 2015133 | In-depth interviews with HCPs using a topic guide. Also allowed participants to raise their own issues, which could be carried forward to subsequent interviews. Analysed using the constant comparative method and systematic open coding. | N= 24 clinicians (doctors, nurses and rehab workers) sampled from three healthcare settings: primary, community, and hospital in each of three geographical locations (i.e. nine settings total). | Gain an understanding of the issues facing clinicians as they care for people with heart failure in the light of recent developments including the introduction of specialist heart failure nurses. | Setting: UK. Locations were healthcare networks in South West, South Central and the Midlands with different models for providing HF care. |
| Heckman 2014144 | Qualitative descriptive study about HF management in care homes, nested in a mixed-methods protocol. Three semi-structured focus groups of HCP. Data was analysed using thematic content analysis by two researchers. Findings were presented back to the participants. | N= 18 HCP: 16 primary care physicians and 2 nurse practitioners who provided care to one of three long-term care facilities chosen to offer variety. | Explore perceptions of HCP regarding HF care in care homes, particularly why these HF pt were less likely to be receiving medication, despite the high burden of disease and acute care episodes. | Part of programme aiming to develop care processes to manage HF in care homes. Setting: Northern Ontario, Canada |
| Lord 2015202 | Qualitative, service evaluation study. Semi-structured interviews with HCP. Data collated and analysed using Framework Method. Initial findings were fed back to the participants. | N= 21 HCP involved in the delivery of HF from three trusts with different models of providing HF care: 8 nurses, 6 consultants, 2 senior managers, 3 commissioners & 4 GPs. | Understand how HF services are delivered in three different trusts, and especially how 1° and 2° care interact to provide continuity of care for HF pt in a context of increasing demand and financial pressure. | Setting: UK, three settings in Birmingham and the Black Country. |
| Macdonald 2016207 | Secondary analysis of qualitative data of transcripts of interviews with pt. Use form of amplified analysis to fit themes to the Candidacy framework. | N=20 CHF pt (a selection of transcripts from two previous HF studies) Age: range 56-86 Severity: 10 advanced and 10 “stable” | Contrast the helpseeking and access to care in cancer and heart disease in order to extend concepts about illness identity, and its relationship to the concept of “Candidacy” | Compares CHF with cancer. Data was taken from the Colorectal Cancer, End-Stage HF and Stable HF studies. Setting: UK, region not stated |
| MacKenzie 2010209 | Mixed methods service evaluation of a new HF nurse service. Used a questionnaire sent to HCP for gathering quantitative and qualitative data. Free text boxes allowed for responses to four sections. No detail on analysis. | N= 86; 83 GPs (32% of those mailed) and all 3 HF specialist nurses returned questionnaires, although not stated how many added free text. | To assess acceptability and effectiveness of a new community based nurse-led HF service in an area with a dispersed population; assess the knowledge and needs of the GPs and assess the perceptions of national guidance. | Setting: UK, the Highlands Although in context of the NHS, the new HF nurse posts were funded by a charity. |
| Nordgren 2007225 | Qualitative study from lifeworld perspective. Unstructured interviews with “middle-aged” pt with CHF(65 and under), with focus on eliciting lived experience of care. Used phenomenological analysis. | N= 7 pt currently attending HF clinic aged 65 and under, chosen for richness and variety of experience. Age: range 39-65 Severity: moderate to severe with at least one hospitalisation. | Explore how “middle-aged” people with moderate-severe HF experience and understand formal care. | Setting: HF clinic in Sweden |
| Sanders 2008294 | Qualitative study nested in a larger project. Semi-structured interviews with HCP. Coded according to themes, subsequently explored in relation to the literature, using a variation of the constant comparison method. | N= 33 HCP, including GPs (7), HF nurses (10), cardiologists (8) and geriatricians (8), from ten sites, chosen for variety. | Explore views of HCP on managing heart failure pt. | Part of bigger project around communication in HF (unpublished). Setting: UK, in multiple sites in North of England |
| Tait 2015187,325 | Qualitative, using Complex Adaptive System (CAS) theory. Interviews with pt to identify all other people involved in their care, followed by attempts to interview all in these networks. A constant comparison method to improve interview. Used constructivist grounded theory to build an explanatory theory. | N= 50 pt networks, including specialist HF services and at least two of the pts’ carers. Carers included family/informal care, caring professionals and healthcare professionals from both specialist and general services. Some HCP appeared in more than one pt network). Sampled to enrich applicability to palliative care. Age (pt): Not stated Severity: NYHA III-IV | Better understand the behaviour of the teams providing heart failure care to those with advanced HF in order to plan how best palliative care services can integrate into these teams. | Setting: Five Canadian cities in three provinces. |
Abbreviations: Pt = people with chronic heart failure, HCP = healthcare professional
From: 9, Referral and approach to care
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.