Designing a Home Care Model for Patients with Heart Failure: A Mixed Method Study

Abstract

Background and purpose: A major reason for readmission in patients with heart failure is inadequate transfer of care from hospital to home. The aim of this study was to design a comprehensive model of home care for these patients. Materials and methods: This mixed-method study was performed in Rasht Heshmat Hospital in 2020-21. In qualitative phase, interviews were conducted with 28 people, selected by purposeful sampling. In quantitative phase (descriptive cross-sectional design), 115 patients were selected via convenience sampling. They were studied using a demographic questionnaire, European Heart Failure Self-care Behavior Scale, Heart Failure Knowledge Scale, Medication Adherence Report Scale, and Minnesota Living with Heart Failure Questionnaire. Qualitative data analysis was performed by conventional content analysis method and quantitative data were analyzed using descriptive statistics. Then, data of two phases were combined to design a care model using matrix analysis. Results: The mean scores for patients' self-care, knowledge, medication adherence, and quality-of-life were 24.49±11.82, 27.25±8.36, 82.09±14.69, and 52.46±9.57, respectively, out of 100 scores. The care model designed included eight components: 1-Providing a comprehensive and organized care program to meet the care needs, 2-Establishing appropriate relationship, 3-Enhancing support systems, 4-Improving self-care, 5-Enhancing adaptation to chronic disease, 6-Family-centered care, 7-Management of health-seeking behavior, and 8-Improving quality-of-life. Conclusion: This model is a comprehensive model for caring patients with heart failure and unlike other models does not have many shortcomings, therefore, it can help in more successful control of the problems associated with heart failure in patient, family, care team, and health care systems.

Keywords

• home care model
• patient
• mixed method
• heart failure