Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota
Objective Patients with heart failure (HF) perform a variety of self-care activities to control symptoms and minimise the risk of HF decompensations. The objective of this study was to understand how patients build capacity and manage the work of living with HF.Design A qualitative study using semi-...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2024-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/12/e088127.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841536721661984768 |
|---|---|
| author | Dawn Finnie Víctor M Montori Jamie Smith Margaret M Redfield Jill M Killian Nathan Shippee Shannon Dunlay |
| author_facet | Dawn Finnie Víctor M Montori Jamie Smith Margaret M Redfield Jill M Killian Nathan Shippee Shannon Dunlay |
| author_sort | Dawn Finnie |
| collection | DOAJ |
| description | Objective Patients with heart failure (HF) perform a variety of self-care activities to control symptoms and minimise the risk of HF decompensations. The objective of this study was to understand how patients build capacity and manage the work of living with HF.Design A qualitative study using semi-structured telephone interviews. The interview guide was informed by the Cumulative Complexity Model, a conceptual framework that focuses on a patient’s workload and their capacity to manage that work. Interview transcripts were analysed using a mixed inductive and deductive coding approach with organisation into larger thematic categories.Setting Southeastern Minnesota USA (11 counties) with capture of data from local community healthcare providers under the auspices of the Rochester Epidemiology Project.Participants Intentional sampling of local patients with HF (n=24, median age 69.5 years, 54% women, 63% rural, 54% preserved ejection fraction) who reported high treatment burden and/ or poor health status on a questionnaire.Results Three major themes emerged: using capacity to manage workload, disruptions resulting in workload exceeding capacity and regaining workload-capacity balance. Participants described routinising the daily tasks associated with living with HF to minimise the associated burden and identified disruptions to their routines, including hospitalisations, emergency room visits, worsening health status and changes in healthcare access. To accommodate disruptions and regain workload-capacity balance, participants decreased workload and/or transferred tasks to others to maximise capacity.Conclusions Participants with HF described managing patient workload in times of stable health, but they sometimes struggled to accommodate disruptions and worsening health status. These findings can inform the design of interventions to minimise workload, maximise capacity and improve quality of life for patients with HF. |
| format | Article |
| id | doaj-art-5f99b49242c04403a37e54e54df05534 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-5f99b49242c04403a37e54e54df055342025-01-14T11:35:11ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-088127Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern MinnesotaDawn Finnie0Víctor M Montori1Jamie Smith2Margaret M Redfield3Jill M Killian4Nathan Shippee5Shannon Dunlay61 Mayo Clinic, Rochester, Minnesota, USARewoldt professor of medicine1 Mayo Clinic, Rochester, Minnesota, USA1 Mayo Clinic, Rochester, Minnesota, USA3 Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA2 University of Minnesota Twin Cities, Minneapolis, Minnesota, USA5 Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USAObjective Patients with heart failure (HF) perform a variety of self-care activities to control symptoms and minimise the risk of HF decompensations. The objective of this study was to understand how patients build capacity and manage the work of living with HF.Design A qualitative study using semi-structured telephone interviews. The interview guide was informed by the Cumulative Complexity Model, a conceptual framework that focuses on a patient’s workload and their capacity to manage that work. Interview transcripts were analysed using a mixed inductive and deductive coding approach with organisation into larger thematic categories.Setting Southeastern Minnesota USA (11 counties) with capture of data from local community healthcare providers under the auspices of the Rochester Epidemiology Project.Participants Intentional sampling of local patients with HF (n=24, median age 69.5 years, 54% women, 63% rural, 54% preserved ejection fraction) who reported high treatment burden and/ or poor health status on a questionnaire.Results Three major themes emerged: using capacity to manage workload, disruptions resulting in workload exceeding capacity and regaining workload-capacity balance. Participants described routinising the daily tasks associated with living with HF to minimise the associated burden and identified disruptions to their routines, including hospitalisations, emergency room visits, worsening health status and changes in healthcare access. To accommodate disruptions and regain workload-capacity balance, participants decreased workload and/or transferred tasks to others to maximise capacity.Conclusions Participants with HF described managing patient workload in times of stable health, but they sometimes struggled to accommodate disruptions and worsening health status. These findings can inform the design of interventions to minimise workload, maximise capacity and improve quality of life for patients with HF.https://bmjopen.bmj.com/content/14/12/e088127.full |
| spellingShingle | Dawn Finnie Víctor M Montori Jamie Smith Margaret M Redfield Jill M Killian Nathan Shippee Shannon Dunlay Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota BMJ Open |
| title | Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota |
| title_full | Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota |
| title_fullStr | Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota |
| title_full_unstemmed | Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota |
| title_short | Managing the work of living with heart failure: a qualitative study using the cumulative complexity model from Southeastern Minnesota |
| title_sort | managing the work of living with heart failure a qualitative study using the cumulative complexity model from southeastern minnesota |
| url | https://bmjopen.bmj.com/content/14/12/e088127.full |
| work_keys_str_mv | AT dawnfinnie managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT victormmontori managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT jamiesmith managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT margaretmredfield managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT jillmkillian managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT nathanshippee managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota AT shannondunlay managingtheworkoflivingwithheartfailureaqualitativestudyusingthecumulativecomplexitymodelfromsoutheasternminnesota |