Issues and Measures Regarding Self-management Practice at Home by Older Adult Patients with Chronic Cardiac Failure Observed from Ward Nurse’s Viewpoints

Abstract

  This study aimed to identify issues experienced by ward nurses regarding self-management practice performed at home by older adult patients with chronic cardiac failure and clarify effective measures for the problems identified. Semi-structured interview sessions were conducted on 21 ward nurses. The results of qualitative and descriptive analyses of the obtained interview data identified seven categories regarding issues, such as [Having difficulties in changing the lifestyle they followed], and eight categories regarding measures for the issues, including [Changing methods to those easier for the patient and the family to understand and manage]. The ward nurses provided patients and their families with easy-to-understand key points in self-management practices at home so that the patients and their families could obtain correct knowledge about heart failure. For the patients and families with little awareness of the seriousness of their conditions, the ward nurses make necessary interventions to make them understand the severity of heart failure and the possibility that the condition would lead to severe consequences from insufficient lifestyle management. At the same time, the ward nurses also kept in mind to make advanced care planning-oriented interventions, asking older adult patients how they wished to live the rest of their lives and suggesting alternatives in self-management practices that would agree with their customs and activities associated with their hobbies and daily habits. In other words, the study results showed that the ward nurses provided specific support different from the one for patients in their adulthood, mindful of conditions of older adult patients with chronic cardiac failure.