![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
ABSTRACT
Purpose: Chronic heart failure patients are often rehospitalized because they fail to seek appropriate, timely care. However, both patients and nurses experience difficulties in detecting signs of heart failure exacerbation. We aimed to qualitatively investigate how visiting nurses detect symptoms of disease progression in chronic heart failure patients in their homes.
Methods: Participants were three experienced home-visit chronic heart failure nurses who completed one-to-one interviews. Data were analysed using the qualitative synthesis method (KJ method).
Results: Six themes were identified that reflected detection of disease exacerbation and nursing support to prevent disease progression: difficulty of judging deterioration in patients with comorbidities; ascertaining conditions needing immediate intervention; detection of illness progression from changes in the patient’s appearance; inferring instability in physical condition from patients’ concerns and questions; arranging to ensure continued management of the patient post discharge; and instructing patients to ensure they never return to their old habits.
Conclusions: The findings indicate that nurses experience challenges in detecting illness progression and judging when outpatient or hospital care is needed. However, nurses use a range of signs and symptoms to determine deterioration. Home-visit nurses thus play a crucial role in the post-hospital care of chronic heart failure patients.
Acknowledgments
This work was supported by JSPS KAKENHI Grant Number 25670945.
Disclosure statement
The authors declare that there is no conflict of interests regarding this manuscript.
Additional information
Funding
Notes on contributors
Chinatsu Taniguchi
Chinatsu Taniguchi is currently an Invited Researcher at the Graduate School of Medicine, Osaka University, Japan. She was an Assistant Professor at the School of Nursing, Mukogawa Women's University, from 2015 to 2019. Her area of interests is in nursing for people with chronic heart failure.
Ayako Okada
Dr. Ayako Okada is a professor of Japanese Red Cross College of Nursing, Japan. Dr. Okada acquired a variety of experiences that faculty of nursing school, head nurse in cardiovascular ward, vice-director of nursing department in a hospital, and part time faculty for graduate students in Clinical Nurse Specialist (CNS) studies in Japan. Her area of interests is in cardiovascular nursing, especially diseases prevention and risk reduction with Japanese population especially focusing on patients with coronary heart diseases and congestive heart failure. The theme current her research project was to develop smoking cessation support program for hospitalized patients with cardiovascular diseases. Simultaneously, Dr. Okada work on to establish the cardiovascular nursing specialty and educate nurses to prepare for advance practice nurses in Japan to improve patient outcome.
Natsuko Seto
Dr. Natsuko Seto is a Professor at the Faculty of Nursing / Graduate School of Nursing, Kansai Medical University, Japan. She was an Associate Professor at Osaka University, Japan. She works in chronic care nursing and educates Certified Nursing Specialists (Chronic Care Nursing) at the graduate school. Her team mainly performs nursing research on people with diabetes, chronic heart failure and inflammatory bowel disease. Besides that, they are conducting research on the working environment of nurses, including the relationship between incidents and the condition (feeling, fatigue, sleep, etc.) of nurses.
Yasuko Shimizu
Dr. Yasuko Shimizu is a Professor at the Graduate School of Medicine, Osaka University, Japan. Her research interests include self-care and support for people with chronic illness.She is a licensed basic trainer of the qualitative synthesis method (KJ method).