Identifying Specific Needs of Chronic Heart Failure Patients on Respiratory Support and Cardiac Resynchronization Therapy

Abstract

　The purpose of the present study was to identify specific needs of chronic heart failure patients who are on cardiac （CRT） and continuous positive airway pressure （CPAP） therapy. Patients who underwent CRT/CPAP therapy for at least 6 months and visited our hospital as outpatients were included in the study after their consents were obtained. A semi-structured interview was conducted, and the responses were analyzed qualitatively. Our subjects consisted of 20 patients （13 male, 7 female） with a mean age of 72.4 years. Of them, 10 patients underwent CRT alone, 8 patients underwent CPAP therapy alone, and 2 patients underwent both CRT and CPAP therapy. Based on the responses from the interviews, we identified 13 categories that described the needs of patients receiving CRT/CPAP therapy. Among them, the following were considered specific to patients undergoing CRT/CPAP therapy: 1） I experienced pain associated with CRT/CPAP therapy, 2） I do not understand the purpose and effects of CRT/CPAP therapy, 3） I would have liked to get more information on social resources and employment after CRT/CPAP therapy, 4） I have difficulty wearing the mask during CPAP therapy, and 5） I experienced stress caused by restrictions and changes in my appearance due to CRT therapy. Collectively, our findings indicate that chronic heart failure patients undergoing CRT/CPAP therapy suffer from shoulder pain and dry mouth associated with CRT/CPAP therapy, have difficulty understanding and properly using the equipment for the treatments, have difficulty obtaining information on social resources and employment, and experience stress due to restrictions and appearance changes that are associated with the treatments. When providing care in an outpatient setting, it is important to recognize that these patients may have specific needs beyond common concerns and to provide appropriate care for those needs.