Nurses' perspectives on the provision of self-care management education to patients with heart failure: A qualitative study at Cardiac Hospital, Dar es Salaam Tanzania.

Abstract

Patients' education along with a motivation for developing self-care management skills is an essential component in the management of heart failure(HF). Self-care management education has been practiced by nurses in many hospitals. However, there is inadequate evidence for the provision of self-care management education in low-income countries including Tanzania. Lack of self-care management education to patients with HF during discharge is the most common reason for re-admission to hospitals. This study aimed to explore nurses' perspectives focusing on facilitators and barriers to the provision of self-care management education to patients with heart failure at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania. This study used a qualitative descriptive design. Purposive sampling was used to recruit 12 study participants. In-depth interviews were used to collect the data. We used thematic analysis to come up with the themes and sub-themes. The two major themes emerged from this study; The first theme is "Improved patient quality of life and health outcome" which describes factors that motivate nurses to continue giving self-care management education to heart failure patients. The second theme is "Reduced effective uptake of self-care management education" which describes nurses'perspectives on barriers for providing self-care management education to heart falure patients. Nurses highlight some barriers while providing self-care management education to patients with heart failure including;inadequate knowledge of self-care management among nurses, lack of privacy during the provision of self-care education, poor communication skills among nurses, and lack of learning materials. Also, nurses pointed out facilitators that influence the provision of self-care management education such as increased involvement of family members and the use of peer educators. Poor self-care management for patients with heart failure results in readmission and prolonged hospital stay. Family involvement and the use of peer educators are the key steps in the improvement of self-care management for patients with HF. However, patient cognitive impairment and poverty which contribute to poor health outcomes, should be taken into consideration when planning for discharge for patients with HF. Self-care management education should be part of routine health care.