Care-seeking delay of patients with heart failure in China: a mixed-method study.

AIM: This study aims to explore the duration and influencing factors of care-seeking delay among patients with heart failure (HF) in China. METHODS AND RESULTS: A convergent mixed method containing a cross-sectional study and two parts of qualitative studies was designed, following the STROBE and COREQ guidelines. Convenience sampling was applied to recruit patients with HF from two general hospitals from December 2021 to December 2022. Purposive sampling was used to enrol healthcare professionals from two general hospitals and two community hospitals from June to November 2022. Among the 258 patients with HF in the cross-sectional study, the median duration of care-seeking delay was 7.5 days. The result integration indicated that the delay duration was influenced by the dyspnoea symptom burden, the oedema symptom burden, and the depression status. The lower dyspnoea symptom burden, the higher oedema symptom burden, and the higher depression score were related to the prolonged care-seeking delay duration. The duration was also affected by the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers. The COVID-19 pandemic, low level of support from medical system, and limited symptom management abilities of caregivers were related to the prolonged care-seeking delay duration. CONCLUSIONS: Care-seeking delay among patients with HF needs attention in China. The duration of care-seeking delay of patients with HF was influenced by the dyspnoea symptom burden, the oedema symptom burden, and depression status, as well as the COVID-19 pandemic, level of support from medical system, and the symptom management abilities of the caregivers.

Development and validation of the self-volume management behaviour questionnaire for patients with chronic heart failure.

AIMS: We aim to develop and validate a questionnaire on the behaviour of self-volume management of patients with chronic heart failure. METHODS AND RESULTS: Based on the specific situation theory of heart failure self-care, the items of this questionnaire were formed through literature review and expert consultation. Content validity is judged by expert consultation. Item analysis was used for further filter entries. Cronbach's alpha and retest were used for reliability. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity. The questionnaire finally contained 3 subscales and 22 items. The Cronbach's α was between 0.732 and 0.797. The reliability of the retest was between 0.983 and 0.998. In expert consultation, the I-CVI of each item was 0.92-1, and the S-CVI of each subscale was 0.99, 1.00, and 0.99. In exploratory factor analysis, each subscale has two factors. In confirmatory factor analysis, the model fits of the three subscales were good: χ2/df < 3, RMSEA < 0.08, CFI > 0.9, TLI > 0.9, and SRMR < 0.05. CONCLUSIONS: The study has shown that the questionnaire on the behaviour of self-volume management of patients with chronic heart failure has good reliability and validity. It can be used as an evaluation tool for evaluating the self-volume management behaviour of patients with chronic heart failure.

Nurse-coordinated home-based cardiac rehabilitation for patients with heart failure: A scoping review.

Objectives: This study aimed to review and summarize the studies of nurse-coordinated home-based cardiac rehabilitation for patients with heart failure. Methods: The review was performed using Arksey and O'Malley's scoping review framework. A systematic search was conducted across eight databases, including PubMed, Embase, Web of Science, EBSCO, China Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Journals (CSTJ) Database, and Chinese Clinical Trial Registry, from inception to 30 April 2023. Articles relevant to the nurse-coordinated home-based cardiac rehabilitation for patients with heart failure were included. Results: Eighteen studies were included in this review. These studies showed that nurses primarily focused on patient assessment, home-based cardiac rehabilitation planning and guidance, and follow-up. The studies also reported positive outcomes in patient safety, feasibility, and efficacy of the programs coordinated by nurses. Conclusions: Home-based cardiac rehabilitation coordinated by nurses is beneficial to patients with heart failure. Future research will explore the potential of nurses in home-based cardiac rehabilitation for patients with heart failure, determine optimal evaluation criteria, and formulate safe, effective, and economical rehabilitation programs suitable for the patients.

The role of patient volunteers in Fangcang Shelter Hospital during the Omicron wave of COVID-19 pandemic in Shanghai, China: a qualitative study.

Objective: During the Omicron wave of the COVID-19 pandemic in Shanghai, Fangcang Shelter Hospital (FSH) served as the major way in patient quarantine. Many COVID patients served as volunteers in FSH providing a lot of assistance for the medical workers and other COVID patients. The aim of this study was to explore the experiences of patient volunteers in FSH. It helps health professionals better understand their motivational incentives and barriers in their volunteer work, and improves recruiting and managing volunteers in subsequent public health emergencies. Methods: This is a qualitative study using semi-structured interviews. Thirteen patient volunteers working in an FSH in Shanghai were included. Thematic analysis was applied to data analysis. Results: Four themes and nine subthemes were identified. The wishes to give back to society and the responsibility of politics and religion were the main reasons for the patients to serve as volunteers in FSH. The patient volunteers served as the bridge to reduce the communication barriers between other patients and healthcare professionals. They also provided support in supply distribution and psychological counseling. They viewed voluntary work as a usual task and tried to solve the barriers in their work. In turn, the voluntary work brought them benefits in mental and physical health, as well as another chance for growth. Conclusion: Working as volunteers in FSHs not only brought personal benefits to the COVID patients but also fulfilled the needs of the healthcare system during public health emergencies. The mode of mutual help between patients could be taken as an example in other public health emergencies.

Empowered But Isolated: A Qualitative Research on Experiences of Family Caregivers of Patients With Acute Heart Failure in China.

BACKGROUND: Family caregivers play crucial roles in the self-management of patients with heart failure (HF). However, little is known about caregiving experiences of Chinese family caregivers during acute HF. OBJECTIVE: The aim of this study was to describe Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. METHODS: This is an exploratory, qualitative study using the Consolidated Criteria for Reporting Qualitative Research guidelines. Data were collected through semistructured interviews and analyzed with thematic analysis. FINDINGS: A total of 21 family caregivers of patients with acute HF were enrolled in this study. "Empowered but isolated" was identified as the overarching theme during data analysis, including 3 themes and 6 subthemes: (1) "Responsible symptom managers: leading the home-based symptom management," including 2 subthemes, "Proxy in symptom management" and "Only knowing the surface, instead of the truth"; (2) "Powerless anchors: care-seeking is a torturous journey," including 2 subthemes, "Facing discrepancies in care-seeking" and "Seeing a doctor is the last choice"; (3) "Carrying the weight forward: responsibility combing with emotional burnout," including 2 subthemes, "Living on tenterhooks" and "Submitting to fate." CONCLUSIONS: In this study, we described Chinese family caregivers' experiences in symptom management and care-seeking during acute HF. Although empowered as proxy, they were also isolated bearing a great burden, receiving insufficient support from patients, family, and the medical system.